Reversal of outflow tract ventricular premature depolarizationinduced cardiomyopathy with ablation: Effect of residual arrhythmia burden and preexisting cardiomyopathy on outcome

Stavros E. Mountantonakis, David S. Frankel, Edward P. Gerstenfeld, Sanjay Dixit, David Lin, Mathew D. Hutchinson, Michael Riley, Rupa Bala, Joshua Cooper, David Callans, Fermin Garcia, Erica S. Zado, Francis E. Marchlinski

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

Background: Outflow tract ventricular premature depolarizations (VPDs) can be associated with reversible left ventricular cardiomyopathy (LVCM). Limited data exist regarding the outcome after ablation of outflow tract VPDs from the LV and the impact of residual VPDs or preexisting LVCM prior to the diagnosis of VPDs on recovery of LV function. Objective: To examine the safety, efficacy, and long-term effect of radiofrequency ablation on LV function in patients with LVCM and frequent outflow tract VPDs and examine the effect of ablation in patients with LVCM known to precede the onset of VPDs and the impact of residual VPD frequency on recovery of LV function. Methods: Sixty-nine patients (43 men; age 51 ± 16 years) with nonischemic LVCM (left ventricular ejection fraction [LVEF] 35% ± 9%, left ventricular diastolic diameter [LVDD] 5.8 ± 0.7 cm) were referred for ablation of frequent outflow tract VPDs (29% ± 13%). Results: VPDs originated in the right ventricular outflow tract in 27 (39%) patients and the left ventricular outflow tract in 42 (61%) patients. After follow-up of 11 ± 6 months, 44 (66%) patients had rare (80% reduction and always 80%) reduction in VPD burden has comparable improvement in LV function to complete VPD elimination. Successful VPD ablation may be beneficial even in patients with preexisting LVCM.

Original languageEnglish (US)
Pages (from-to)1608-1614
Number of pages7
JournalHeart Rhythm
Volume8
Issue number10
DOIs
StatePublished - Oct 2011
Externally publishedYes

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Cardiomyopathies
Cardiac Arrhythmias
Recovery of Function
Stroke Volume
Safety

Keywords

  • Cardiomyopathy
  • Catheter ablation
  • Heart failure
  • Outflow tract
  • Palpitations
  • Ventricular premature depolarization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Reversal of outflow tract ventricular premature depolarizationinduced cardiomyopathy with ablation : Effect of residual arrhythmia burden and preexisting cardiomyopathy on outcome. / Mountantonakis, Stavros E.; Frankel, David S.; Gerstenfeld, Edward P.; Dixit, Sanjay; Lin, David; Hutchinson, Mathew D.; Riley, Michael; Bala, Rupa; Cooper, Joshua; Callans, David; Garcia, Fermin; Zado, Erica S.; Marchlinski, Francis E.

In: Heart Rhythm, Vol. 8, No. 10, 10.2011, p. 1608-1614.

Research output: Contribution to journalArticle

Mountantonakis, SE, Frankel, DS, Gerstenfeld, EP, Dixit, S, Lin, D, Hutchinson, MD, Riley, M, Bala, R, Cooper, J, Callans, D, Garcia, F, Zado, ES & Marchlinski, FE 2011, 'Reversal of outflow tract ventricular premature depolarizationinduced cardiomyopathy with ablation: Effect of residual arrhythmia burden and preexisting cardiomyopathy on outcome', Heart Rhythm, vol. 8, no. 10, pp. 1608-1614. https://doi.org/10.1016/j.hrthm.2011.04.026
Mountantonakis, Stavros E. ; Frankel, David S. ; Gerstenfeld, Edward P. ; Dixit, Sanjay ; Lin, David ; Hutchinson, Mathew D. ; Riley, Michael ; Bala, Rupa ; Cooper, Joshua ; Callans, David ; Garcia, Fermin ; Zado, Erica S. ; Marchlinski, Francis E. / Reversal of outflow tract ventricular premature depolarizationinduced cardiomyopathy with ablation : Effect of residual arrhythmia burden and preexisting cardiomyopathy on outcome. In: Heart Rhythm. 2011 ; Vol. 8, No. 10. pp. 1608-1614.
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abstract = "Background: Outflow tract ventricular premature depolarizations (VPDs) can be associated with reversible left ventricular cardiomyopathy (LVCM). Limited data exist regarding the outcome after ablation of outflow tract VPDs from the LV and the impact of residual VPDs or preexisting LVCM prior to the diagnosis of VPDs on recovery of LV function. Objective: To examine the safety, efficacy, and long-term effect of radiofrequency ablation on LV function in patients with LVCM and frequent outflow tract VPDs and examine the effect of ablation in patients with LVCM known to precede the onset of VPDs and the impact of residual VPD frequency on recovery of LV function. Methods: Sixty-nine patients (43 men; age 51 ± 16 years) with nonischemic LVCM (left ventricular ejection fraction [LVEF] 35{\%} ± 9{\%}, left ventricular diastolic diameter [LVDD] 5.8 ± 0.7 cm) were referred for ablation of frequent outflow tract VPDs (29{\%} ± 13{\%}). Results: VPDs originated in the right ventricular outflow tract in 27 (39{\%}) patients and the left ventricular outflow tract in 42 (61{\%}) patients. After follow-up of 11 ± 6 months, 44 (66{\%}) patients had rare (80{\%} reduction and always 80{\%}) reduction in VPD burden has comparable improvement in LV function to complete VPD elimination. Successful VPD ablation may be beneficial even in patients with preexisting LVCM.",
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T1 - Reversal of outflow tract ventricular premature depolarizationinduced cardiomyopathy with ablation

T2 - Effect of residual arrhythmia burden and preexisting cardiomyopathy on outcome

AU - Mountantonakis, Stavros E.

AU - Frankel, David S.

AU - Gerstenfeld, Edward P.

AU - Dixit, Sanjay

AU - Lin, David

AU - Hutchinson, Mathew D.

AU - Riley, Michael

AU - Bala, Rupa

AU - Cooper, Joshua

AU - Callans, David

AU - Garcia, Fermin

AU - Zado, Erica S.

AU - Marchlinski, Francis E.

PY - 2011/10

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N2 - Background: Outflow tract ventricular premature depolarizations (VPDs) can be associated with reversible left ventricular cardiomyopathy (LVCM). Limited data exist regarding the outcome after ablation of outflow tract VPDs from the LV and the impact of residual VPDs or preexisting LVCM prior to the diagnosis of VPDs on recovery of LV function. Objective: To examine the safety, efficacy, and long-term effect of radiofrequency ablation on LV function in patients with LVCM and frequent outflow tract VPDs and examine the effect of ablation in patients with LVCM known to precede the onset of VPDs and the impact of residual VPD frequency on recovery of LV function. Methods: Sixty-nine patients (43 men; age 51 ± 16 years) with nonischemic LVCM (left ventricular ejection fraction [LVEF] 35% ± 9%, left ventricular diastolic diameter [LVDD] 5.8 ± 0.7 cm) were referred for ablation of frequent outflow tract VPDs (29% ± 13%). Results: VPDs originated in the right ventricular outflow tract in 27 (39%) patients and the left ventricular outflow tract in 42 (61%) patients. After follow-up of 11 ± 6 months, 44 (66%) patients had rare (80% reduction and always 80%) reduction in VPD burden has comparable improvement in LV function to complete VPD elimination. Successful VPD ablation may be beneficial even in patients with preexisting LVCM.

AB - Background: Outflow tract ventricular premature depolarizations (VPDs) can be associated with reversible left ventricular cardiomyopathy (LVCM). Limited data exist regarding the outcome after ablation of outflow tract VPDs from the LV and the impact of residual VPDs or preexisting LVCM prior to the diagnosis of VPDs on recovery of LV function. Objective: To examine the safety, efficacy, and long-term effect of radiofrequency ablation on LV function in patients with LVCM and frequent outflow tract VPDs and examine the effect of ablation in patients with LVCM known to precede the onset of VPDs and the impact of residual VPD frequency on recovery of LV function. Methods: Sixty-nine patients (43 men; age 51 ± 16 years) with nonischemic LVCM (left ventricular ejection fraction [LVEF] 35% ± 9%, left ventricular diastolic diameter [LVDD] 5.8 ± 0.7 cm) were referred for ablation of frequent outflow tract VPDs (29% ± 13%). Results: VPDs originated in the right ventricular outflow tract in 27 (39%) patients and the left ventricular outflow tract in 42 (61%) patients. After follow-up of 11 ± 6 months, 44 (66%) patients had rare (80% reduction and always 80%) reduction in VPD burden has comparable improvement in LV function to complete VPD elimination. Successful VPD ablation may be beneficial even in patients with preexisting LVCM.

KW - Cardiomyopathy

KW - Catheter ablation

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KW - Outflow tract

KW - Palpitations

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