Patients with scar-related right ventricular tachycardia: determinants of long-term outcome.

Introduction: Patients with established arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) based on task force (TF) criteria and ventricular tachycardia (VT) are at risk of VT recurrence and sudden death. Data on patients with VT due to right ventricular (RV) scar not fulfilling TF c...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 20; no. 10; pp. 1119 - 1128
Autores principales: Wijnmaalen AP, Schalij MJ, Bootsma M, Kies P, De Roos A, Putter H, Bax JJ, Zeppenfeld K
Formato: equations & formulas research tables/charts Journal Article
Publicado: Wiley-Blackwell Oct2009
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2009
      vid: 20
      iid: 10
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/j.1540-8167.2009.01516.x
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        atl: Patients with scar-related right ventricular tachycardia: determinants of long-term outcome.
      aug:
        au:
          Wijnmaalen AP
          Schalij MJ
          Bootsma M
          Kies P
          De Roos A
          Putter H
          Bax JJ
          Zeppenfeld K
      sug:
        subj:
          Catheter Ablation
          Cicatrix
          Heart Ventricle, Right
          Outcomes Research
          Tachycardia, Ventricular Risk Factors
          Cox Proportional Hazards Model
          Defibrillators, Implantable
          Demography
          Echocardiography
          Electrocardiography
          Electrophysiology
          Equipment and Supplies
          Kaplan-Meier Estimator
          Log-Rank Test
          Magnetic Resonance Imaging
          Multivariate Analysis
          Netherlands
          Regression
          Risk Assessment
          T-Tests
          Human
      ab: Introduction: Patients with established arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) based on task force (TF) criteria and ventricular tachycardia (VT) are at risk of VT recurrence and sudden death. Data on patients with VT due to right ventricular (RV) scar not fulfilling TF criteria are lacking. The purpose of this study was to assess the long-term arrhythmia recurrence rate and outcome in patients with scar-related right VT with and without a diagnosis of ARVC/D. Methods: Sixty-four patients (age 43.5 ± 15 years, 49 males) presenting with nonischemic scar-related VT of RV origin were studied. Scar was identified by electroanatomical mapping, contrast echocardiography, and/or magnetic resonance imaging (MRI). Patients were evaluated and treated according to a standard institute protocol. Results: Twenty-nine (45%) patients were diagnosed with ARVC/D according to TF criteria (TF+) and 35 (55%) with RV scar of undetermined origin (TF-) at the end of follow-up (64 ± 42 months). Patients were treated with antiarrhythmic drugs, radiofrequency catheter ablation, and/or implantable cardioverter-defibrillator (ICD) implantation. VT recurrence-free survival for TF+ and TF- was 76% versus 74% at 1 year and 45% versus 50% at 4 years (P = ns). Patients with fast index VT (cycle length [CL]<= 250 ms, n = 31) were more likely to experience a fast VT during follow-up than patients with a slow index VT (CL > 250 ms, n = 33) (61% vs 3%, P < 0.001). Conclusions: Scar-related RV VTs have a high recurrence rate in TF+ and TF- patients. Patients presenting with a fast index VT are at high risk for fast VT recurrence and may benefit most from ICD therapy.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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