Author + information
- Peter Rothstein,
- Michael Cowherd,
- Matthew Zipse,
- Ryan Borne,
- Jehu Mathew,
- Alexis Tumolo,
- Amneet Sandhu,
- Duy Nguyen,
- Lucas Marzec,
- Ryan Aleong,
- Christine Tompkins,
- William Sauer and
- Wendy Tzou
Background: Effective control of ventricular arrhythmias (VAs) in non-ischemic cardiomyopathy (NICM) can be difficult and require multiple ablations, especially when mid-myocardial substrate is present. This study sought to determine the impact of mid-myocardial substrate on repeat ablation (RA) outcomes in patients with NICM and VA.
Methods: We retrospectively studied NICM patients with VA undergoing RA at a tertiary-referral medical center. One-year VA-free survival was compared in patients with (MMS) and without (NoMMS) mid-myocardial substrate, following 1 RA and ≥1 RA.
Results: Overall, 88 patients were included, of which 26 (30%) had MMS identified. MMS and NoMMS groups did not differ significantly in baseline characteristics, including age (57 ± 16 vs. 56 ± 16 years, p = 0.76), LVEF (38 ± 15% vs. 40 ± 18%, p = 0.67), males (77% vs. 73%, p = 0.79), or amiodarone use (35% vs. 36%, p = 1.00). After 1 RA, freedom from recurrent VA was significantly lower for MMS versus NoMMS (43% vs. 69%, p=0.012, Figure). Among those in whom ≥1 RA was performed due to recurrent VA, VA-free survival in the MMS group improved and was comparable to the NoMMS group (85% vs. 81%, p = 0.69). More repeat procedures were required to achieve VA control in the MMS vs. NoMMS group (2.0 ± 1.0 vs. 1.2 ± 0.4, p < 0.001).
Conclusions: Arrhythmia control in NICM patients with VAs can be effectively achieved with catheter ablation at an experienced center, although multiple ablations may be required, especially among those with mid-myocardial substrate.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Atrial Fibrillation and VT: Unique Populations and Solutions
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1151-107
- 2017 American College of Cardiology Foundation