Department of Cardiology-Electrophysiology, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Germany.
Eur J Med Res. 2020 Mar 17;25(1):4. doi: 10.1186/s40001-020-0400-y.
Catheter ablation of non-reentrant, commonly termed "idiopathic" ventricular arrhythmias (VA) is highly effective in patients without structural heart disease (SHD). Meanwhile, the outcome of catheter ablation of these arrhythmias in patients with SHD remains unclear. This study sought to characterize the outcome of patients with and without SHD undergoing catheter ablation of non-reentrant VA.
In this single-centre study the acute and long-term outcome of 266 consecutive patients undergoing catheter ablation of non-reentrant VA was investigated. In 41.0% of patients a SHD was present (n = 109, 80.7% male, age 59.1 ± 14.7 years), 59.0% had no SHD (n = 157; 44.0% male, age 49.9 ± 16.5 years).
Acute procedural success (absence of spontaneous or provoked VA at the end of procedure and within 48 h after the procedure) was achieved in 89.9% of patients with SHD vs. 94.3% without SHD (p = 0.238). During a mean follow-up of 34.7 ± 15.1 months a repeat catheter ablation was performed in 19.6% of patients with SHD vs. 13.0% without SHD (p = 0.179). Patients with dilated cardiomyopathy (DCM) were the most likely to require a repeat ablation procedure (32.0% of patients with DCM vs. 13.0% without SHD; p = 0.022). Periprocedural complications occurred in 5.5% of patients with SHD vs. 5.7% without SHD (p > 0.999). All complications were managed without sequelae.
The outcome of catheter ablation of non-reentrant VA in patients with SHD appears good and is comparable to patients without SHD. A slightly higher rate of repeat ablations was observed in patients with DCM.
导管消融非折返性、通常称为“特发性”室性心律失常（VA）在无结构性心脏病（SHD）的患者中非常有效。同时，SHD 患者导管消融这些心律失常的结果尚不清楚。本研究旨在描述有和无 SHD 的患者行非折返性 VA 导管消融的结果。
在这项单中心研究中，对 266 例连续行非折返性 VA 导管消融的患者的急性和长期结果进行了研究。41.0%的患者存在 SHD（n=109，80.7%为男性，年龄 59.1±14.7 岁），59.0%无 SHD（n=157；44.0%为男性，年龄 49.9±16.5 岁）。
SHD 患者的急性手术成功率（在程序结束时和程序结束后 48 小时内无自发性或诱发性 VA）为 89.9%，无 SHD 患者为 94.3%（p=0.238）。在平均 34.7±15.1 个月的随访中，SHD 患者中有 19.6%需要再次导管消融，而无 SHD 患者中有 13.0%（p=0.179）。扩张型心肌病（DCM）患者最有可能需要再次消融（DCM 患者中有 32.0%，而无 SHD 患者中有 13.0%；p=0.022）。SHD 患者围手术期并发症发生率为 5.5%，无 SHD 患者为 5.7%（p＞0.999）。所有并发症均无后遗症。
SHD 患者非折返性 VA 导管消融的结果良好，与无 SHD 患者相当。在 DCM 患者中观察到重复消融的比例略高。
