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High Prevalence of Catecholamine-Facilitated Focal Ventricular Tachycardia in Patients with Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy.
MedLine Citation:
PMID:  23275260     Owner:  NLM     Status:  Publisher    
BACKGROUND: -Exercise related ventricular tachycardia (VT) and high burden of premature ventricular contractions (PVCs) are common in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). We hypothesized that VT in ARVD/C shows a high degree of association with the PVC at baseline. METHODS AND RESULTS: -The study population included 16 consecutive ARVD/C patients with recurrent VT who underwent catheter ablation. Median age of the patients was 27 (range 18 - 66) years and 50% were men. All patients had frequent ectopy at baseline with a median PVC count of 7275 (range 1353 - 19084). During EP study a total of 27 VTs were induced of which 16 (59%) occurred during high dose isoproterenol infusion. VT morphology was identical to the baseline PVCs in all the VTs induced during high dose isoproterenol infusion. Focal ablation at the site of earliest activation and 12/12 pacemap of the PVC eliminated the VT in all cases. Target site for focal ablation localized to scar border. Cumulative freedom from VT following ablation was 85.2% and 74.5% at 1 and 2 years, respectively, which was associated with a reduction in PVC count. CONCLUSIONS: -We report a high degree of association between PVCs at baseline and the VTs induced during catecholamine infusion. These VTs originated from the border region of scar most commonly in the right ventricular outflow tract (RVOT) and right ventricle (RV) basal regions. These findings highlight the importance of catecholamine challenge and PVC mapping, which can in turn facilitate ablation of the VT in ARVD/C.
Binu Philips; Srinivasa Madhavan; Cynthia James; Crystal Tichnell; Brittney Murray; Matthew Needleman; Aditya Bhonsale; Saman Nazarian; Kenneth Laurita; Hugh Calkins; Harikrishna Tandri
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-29
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  -     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1 The Johns Hopkins University School of Medicine, Baltimore, MD;
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