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致心律失常性右室心肌病/发育不良患者的室上性心律失常与室性心动过速导管消融后的长期预后相关。

Supraventricular arrhythmias in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy associate with long-term outcome after catheter ablation of ventricular tachycardias.

机构信息

Department of Electrophysiology, University of Leipzig, HELIOS Heart Centre, Strümpellstrasse 39, Leipzig, Germany.

出版信息

Europace. 2018 Jul 1;20(7):1182-1187. doi: 10.1093/europace/eux179.

Abstract

AIMS

This study aimed to assess the impact of supraventricular tachycardia (SVT) on long-term results of radiofrequency catheter ablation therapy of ventricular tachycardia (VT) in a large cohort of patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C).

METHODS AND RESULTS

Supraventricular tachycardia occurrence has been studied in patients from our ARVD/C registry (70 patients, 48 male, age 53.2 ± 14.0, 45 patients (64.3%) with previous VT ablation). SVT were diagnosed in 26 of 70 patients (37.1%). Atrial fibrillation (AF) was the most frequent atrial arrhythmia, diagnosed in 17 patients (24.3%). In univariate analysis advanced age, clinical symptoms of heart failure, enlarged right atrium, diagnosis of significant tricuspid regurgitation (TR), and inappropriate implantable cardioverters-defibrillators therapy were associated with SVT. In binary logistic regression analysis only heart failure: hazard ratio (HR) 10.89, 95% confidence interval (95% CI) 1.08-109.96 (P = 0.043) and significant TR: HR 4.79, 95% CI 1.35-16.33 (P = 0.015) remained associated with SVT. In patients with previous VT ablation Cox multiple regression survival analysis revealed older age (≥53 years): HR 4.63, 95% CI 1.51-14.24 (P = 0.008) and SVT: HR 3.01, 95% CI 1.15-7.89 (P = 0.025) as predictors for VT recurrence during the follow-up.

CONCLUSION

SVT and older age are associated with the recurrence of VT after catheter ablation in patients with ARVD/C.

摘要

目的

本研究旨在评估室上性心动过速(SVT)对致心律失常性右室心肌病/扩张型心肌病(ARVD/C)患者射频导管消融治疗室性心动过速(VT)长期结果的影响。

方法和结果

在我们的 ARVD/C 注册中心(70 例患者,48 例男性,年龄 53.2±14.0 岁,45 例(64.3%)患者曾行 VT 消融)的患者中研究了 SVT 的发生情况。70 例患者中有 26 例(37.1%)诊断为 SVT。心房颤动(AF)是最常见的房性心律失常,17 例(24.3%)诊断为 AF。单因素分析显示,高龄、心力衰竭的临床症状、右心房扩大、诊断为显著三尖瓣反流(TR)和不合适的植入式心脏复律除颤器治疗与 SVT 相关。在二元逻辑回归分析中,只有心力衰竭:风险比(HR)10.89,95%置信区间(95%CI)1.08-109.96(P=0.043)和显著 TR:HR 4.79,95%CI 1.35-16.33(P=0.015)与 SVT 相关。在曾行 VT 消融的患者中,Cox 多因素回归生存分析显示,年龄较大(≥53 岁):HR 4.63,95%CI 1.51-14.24(P=0.008)和 SVT:HR 3.01,95%CI 1.15-7.89(P=0.025)是随访期间 VT 复发的预测因素。

结论

SVT 和年龄较大与 ARVD/C 患者导管消融后 VT 的复发相关。

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