Ezzeddine Fatima M, Davis Nathaniel E, Asirvatham Samuel J, Bois John P, Chang Ian C, Deshmukh Abhishek, Friedman Paul A, Giudicessi John, Kapa Suraj, Kowlgi Gurukripa G, Mulpuru Siva K, Tan Nicholas Y, Siontis Konstantinos C, Sugrue Alan, Killu Ammar M
Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Eur Heart J Open. 2025 May 5;5(3):oeaf049. doi: 10.1093/ehjopen/oeaf049. eCollection 2025 May.
Catheter ablation is commonly performed in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) for management of ventricular arrhythmias (VAs). The impact of catheter ablation on cardiac function is unknown. The aim is to assess the impact of catheter ablation for VAs on cardiac function in patients with ARVC.
This retrospective study included consecutive patients with ARVC who underwent catheter ablation for VAs. Cardiac and valvular functions were assessed on pre- and post-procedure cardiac imaging. The severities of tricuspid regurgitation, pulmonic regurgitation, right ventricular (RV) enlargement, and RV systolic dysfunction was graded as absent (=0), mild (=1), mild-moderate (=2), moderate (=3), moderate-severe (=4), or severe (=5). Thirty-four patients were included. Median age at the time of ablation was 49 [inter-quartile range (IQR), 23] years, and 10 (29%) patients were female. After a median follow-up of 1 (IQR, 0) day, 11 (34%) patients had worsening RV function, and 4 (12%) patients had worsening left ventricular ejection fraction (LVEF) >5%. Five (15%) patients required inotropic support. After a median follow-up of 6.5 (IQR, 6.4) months, 20 (59%) patients had repeat transthoracic echocardiograms. Among patients with worsening RV function post-ablation, one-sixth (17%) had improvement in the RV function at follow-up. In contrast, among patients who had an acute drop in LVEF post-ablation, two-thirds (67%) had improvement at follow-up.
Right ventricular dysfunction following catheter ablation in patients with ARVC is common, affecting one-third of patients. Patients undergoing catheter ablation of VAs should be counselled on the potential negative impact of ablation on cardiac function.
导管消融术常用于致心律失常性右室心肌病（ARVC）患者室性心律失常（VA）的治疗。导管消融对心脏功能的影响尚不清楚。本研究旨在评估导管消融治疗VA对ARVC患者心脏功能的影响。
本回顾性研究纳入了连续接受VA导管消融治疗的ARVC患者。在术前和术后心脏成像上评估心脏和瓣膜功能。三尖瓣反流、肺动脉反流、右心室（RV）扩大和RV收缩功能障碍的严重程度分为无（=0）、轻度（=1）、轻中度（=2）、中度（=3）、中重度（=4）或重度（=5）。共纳入34例患者。消融时的中位年龄为49岁[四分位间距（IQR），23岁]，10例（29%）为女性。中位随访1天（IQR，0天）后，11例（34%）患者的RV功能恶化，4例（12%）患者的左心室射血分数（LVEF）恶化>5%。5例（15%）患者需要使用正性肌力药物支持。中位随访6.5个月（IQR，6.4个月）后，20例（59%）患者进行了重复经胸超声心动图检查。在消融后RV功能恶化的患者中，六分之一（17%）在随访时RV功能有所改善。相比之下，在消融后LVEF急性下降的患者中，三分之二（67%）在随访时有所改善。
ARVC患者导管消融后右心室功能障碍很常见，影响三分之一的患者。应向接受VA导管消融的患者告知消融对心脏功能的潜在负面影响。
