射频导管消融治疗起源于右心室流出道的室性早搏对右心室功能的影响。

Effects of radiofrequency catheter ablation for premature ventricular complexes originating from the right ventricular outflow tract on right ventricular function.

作者信息

Uhm Jae-Sun, Ko Kyu-Yong, Shim Chi Young, Park Je-Wook, Kim Minkwan, Bae SungA, Jung In Hyun, Kim In-Soo, Kim Jong Youn, Choi Eui-Young, Son Won Jeong, Roh Yun Ho, Yu Hee Tae, Kim Tae-Hoon, Hong Geu-Ru, Joung Boyoung, Pak Hui-Nam, Lee Moon-Hyoung

机构信息

Division of Cardiology, Department of Internal Medicine, Yongin Severance Hospital, College of Medicine, Yonsei University, Yongin, Gyeonggi-do, Republic of Korea.

Division of Cardiology, Department of Internal Medicine, Severance Hospital, College of Medicine, Yonsei University, Seoul, Republic of Korea.

出版信息

J Cardiovasc Electrophysiol. 2023 Jan;34(1):189-196. doi: 10.1111/jce.15741. Epub 2022 Nov 15.

DOI:10.1111/jce.15741

PMID:36349711

Abstract

INTRODUCTION

This study aimed to elucidate the relationship between premature ventricular complexes (PVCs) and right ventricular (RV) dysfunction, and the effects of radiofrequency catheter ablation (RFCA) on RV function.

METHODS

A total of 110 patients (age, 50.8 ± 14.4 years; 30 men) without structural heart disease who had undergone RFCA for RV outflow tract (RVOT) PVCs were retrospectively included. RV function was assessed using fractional area change (FAC) and global longitudinal strain (GLS) before and after RFCA. Clinical data were compared between the RV dysfunction (n = 63) and preserved RV function (n = 47) groups. The relationship between PVC burden and RV function was analyzed. Change in RV function before and after RFCA was compared between patients with successful and failed RFCA.

RESULTS

PVC burden was significantly higher in the RV dysfunction group than in the preserved RV function group (p < .001). FAC and GLS were significantly worse in proportion to PVC burden (p < .001 and p < .001, respectively). The risk factor associated with RV dysfunction was PVC burden [odds ratio (95% confidence interval), 1.092 (1.052-1.134); p < .001]. Improvement in FAC (13.0 ± 8.7% and -2.5 ± 5.6%, respectively; p < .001) and GLS (-6.8 ± 5.7% and 2.1 ± 4.2%, respectively; p < .001) was significant in the patients with successful RFCA, compared to the patients in whom RFCA failed.

CONCLUSIONS

Frequent RVOT PVCs are associated with RV dysfunction. RV dysfunction is reversible by successful RFCA.

摘要

引言

本研究旨在阐明室性早搏（PVCs）与右心室（RV）功能障碍之间的关系，以及射频导管消融（RFCA）对右心室功能的影响。

方法

回顾性纳入110例无结构性心脏病且因右心室流出道（RVOT）PVCs接受RFCA的患者（年龄50.8±14.4岁；男性30例）。在RFCA前后使用面积变化分数（FAC）和整体纵向应变（GLS）评估右心室功能。比较右心室功能障碍组（n = 63）和右心室功能保留组（n = 47）的临床数据。分析PVC负荷与右心室功能之间的关系。比较RFCA成功与失败患者RFCA前后右心室功能的变化。

结果

右心室功能障碍组的PVC负荷显著高于右心室功能保留组（p <.001）。FAC和GLS与PVC负荷呈显著负相关（分别为p <.001和p <.001）。与右心室功能障碍相关的危险因素是PVC负荷[比值比（95%置信区间），1.092（1.052 - 1.134）；p <.001]。与RFCA失败的患者相比，RFCA成功的患者FAC（分别为13.0±8.7%和 - 2.5±5.6%；p <.001）和GLS（分别为 - 6.8±5.7%和2.1±4.2%；p <.001）有显著改善。