Mid-Term Outcome of Ventricular Arrhythmias Catheter Ablation in Patients with Chronic Coronary Total Occlusion Compared to Ischemic and Non-Ischemic Patients
Chronic coronary total occlusions (CTO) are considered an emerging predictor of ventricular arrhythmias (VAs), but currently there are few data on arrhythmic outcomes in patients affected by CTO undergoing radiofrequency catheter ablation of VAs. This study sought to evaluate the impact of unrevascu...
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| Format: | Article |
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MDPI AG
2022-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/23/7181 |
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| author | Maria Lucia Narducci Giampaolo Niccoli Francesco Flore Francesco Perna Gianluigi Bencardino Rocco Antonio Montone Gemma Pelargonio Filippo Crea |
| author_facet | Maria Lucia Narducci Giampaolo Niccoli Francesco Flore Francesco Perna Gianluigi Bencardino Rocco Antonio Montone Gemma Pelargonio Filippo Crea |
| author_sort | Maria Lucia Narducci |
| collection | DOAJ |
| description | Chronic coronary total occlusions (CTO) are considered an emerging predictor of ventricular arrhythmias (VAs), but currently there are few data on arrhythmic outcomes in patients affected by CTO undergoing radiofrequency catheter ablation of VAs. This study sought to evaluate the impact of unrevascularized CTO on the recurrence of VAs after catheter ablation. This was a single-center retrospective study enrolling 120 patients between 2015 and 2020. All patients were admitted for ventricular tachycardia (VT) or high premature ventricular contractions burden (>25% detected by Holter ECG), without evidence of acute coronary syndrome; they underwent coronary angiography, electrophysiology (EP) study, and three-dimensional electroanatomic mapping (3D-EAM) followed by VAs ablation. Twenty-eight patients (23%) of 120 patients showed CTO at coronary angiography. At baseline, the CTO group presented with higher prevalence of hypertension, chronic renal disease, systolic ventricular dysfunction, secondary prevention ICD implantation, and higher rate of LAVA by 3D-EAM compared with the non-CTO group. At a median follow-up of 15 months (range 1–96 months) after catheter ablation, the only independent predictor of VAs recurrence was the presence of moderate to severe left ventricular (LV) dysfunction. Therefore, the presence of CTO does not predict VAs recurrence after catheter ablation, which is instead predicted by LV dysfunction. |
| first_indexed | 2024-03-09T17:43:15Z |
| format | Article |
| id | doaj.art-19da457b4c5c431a94dcad741d54c5ff |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T17:43:15Z |
| publishDate | 2022-12-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-19da457b4c5c431a94dcad741d54c5ff2023-11-24T11:24:18ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-011123718110.3390/jcm11237181Mid-Term Outcome of Ventricular Arrhythmias Catheter Ablation in Patients with Chronic Coronary Total Occlusion Compared to Ischemic and Non-Ischemic PatientsMaria Lucia Narducci0Giampaolo Niccoli1Francesco Flore2Francesco Perna3Gianluigi Bencardino4Rocco Antonio Montone5Gemma Pelargonio6Filippo Crea7Dipartimento di Scienze Cardiovascolari, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, ItalyDipartimento di Medicina e Chirurgia, Università di Parma, 43125 Parma, ItalyDipartimento di Scienze Cardiovascolari, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, ItalyDipartimento di Scienze Cardiovascolari, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, ItalyDipartimento di Scienze Cardiovascolari, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, ItalyDipartimento di Scienze Cardiovascolari, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, ItalyIstituto di Cardiologia Università Cattolica del Sacro Cuore Roma, Department of Cardiovascular Sciences, 00168 Rome, ItalyIstituto di Cardiologia Università Cattolica del Sacro Cuore Roma, Department of Cardiovascular Sciences, 00168 Rome, ItalyChronic coronary total occlusions (CTO) are considered an emerging predictor of ventricular arrhythmias (VAs), but currently there are few data on arrhythmic outcomes in patients affected by CTO undergoing radiofrequency catheter ablation of VAs. This study sought to evaluate the impact of unrevascularized CTO on the recurrence of VAs after catheter ablation. This was a single-center retrospective study enrolling 120 patients between 2015 and 2020. All patients were admitted for ventricular tachycardia (VT) or high premature ventricular contractions burden (>25% detected by Holter ECG), without evidence of acute coronary syndrome; they underwent coronary angiography, electrophysiology (EP) study, and three-dimensional electroanatomic mapping (3D-EAM) followed by VAs ablation. Twenty-eight patients (23%) of 120 patients showed CTO at coronary angiography. At baseline, the CTO group presented with higher prevalence of hypertension, chronic renal disease, systolic ventricular dysfunction, secondary prevention ICD implantation, and higher rate of LAVA by 3D-EAM compared with the non-CTO group. At a median follow-up of 15 months (range 1–96 months) after catheter ablation, the only independent predictor of VAs recurrence was the presence of moderate to severe left ventricular (LV) dysfunction. Therefore, the presence of CTO does not predict VAs recurrence after catheter ablation, which is instead predicted by LV dysfunction.https://www.mdpi.com/2077-0383/11/23/7181personalized medicineventricular arrhythmiasradiofrequency catheter ablationcoronary chronic total occlusiontherapeutic strategy |
| spellingShingle | Maria Lucia Narducci Giampaolo Niccoli Francesco Flore Francesco Perna Gianluigi Bencardino Rocco Antonio Montone Gemma Pelargonio Filippo Crea Mid-Term Outcome of Ventricular Arrhythmias Catheter Ablation in Patients with Chronic Coronary Total Occlusion Compared to Ischemic and Non-Ischemic Patients Journal of Clinical Medicine personalized medicine ventricular arrhythmias radiofrequency catheter ablation coronary chronic total occlusion therapeutic strategy |
| title | Mid-Term Outcome of Ventricular Arrhythmias Catheter Ablation in Patients with Chronic Coronary Total Occlusion Compared to Ischemic and Non-Ischemic Patients |
| title_full | Mid-Term Outcome of Ventricular Arrhythmias Catheter Ablation in Patients with Chronic Coronary Total Occlusion Compared to Ischemic and Non-Ischemic Patients |
| title_fullStr | Mid-Term Outcome of Ventricular Arrhythmias Catheter Ablation in Patients with Chronic Coronary Total Occlusion Compared to Ischemic and Non-Ischemic Patients |
| title_full_unstemmed | Mid-Term Outcome of Ventricular Arrhythmias Catheter Ablation in Patients with Chronic Coronary Total Occlusion Compared to Ischemic and Non-Ischemic Patients |
| title_short | Mid-Term Outcome of Ventricular Arrhythmias Catheter Ablation in Patients with Chronic Coronary Total Occlusion Compared to Ischemic and Non-Ischemic Patients |
| title_sort | mid term outcome of ventricular arrhythmias catheter ablation in patients with chronic coronary total occlusion compared to ischemic and non ischemic patients |
| topic | personalized medicine ventricular arrhythmias radiofrequency catheter ablation coronary chronic total occlusion therapeutic strategy |
| url | https://www.mdpi.com/2077-0383/11/23/7181 |
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