Ablation of Outflow Tract Arrhythmias in Patients With and Without Structural Heart Disease—A Comparative Analysis
IntroductionCatheter ablation of ventricular arrhythmias emerging from the ventricular outflow tracts and adjacent structures is very effective and considered almost curative in patients without structural heart disease (SHD). Outcomes of patients with SHD undergoing ablation of outflow tract arrhyt...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-05-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.910042/full |
| _version_ | 1818551569528913920 |
|---|---|
| author | Ruben Schleberger Ruben Schleberger Jan Riess Anika Brauer Hans O. Pinnschmidt Laura Rottner Laura Rottner Fabian Moser Julia Moser Shinwan Kany Ilaria My Marc D. Lemoine Marc D. Lemoine Bruno Reissmann Christian Meyer Christian Meyer Andreas Metzner Feifan Ouyang Feifan Ouyang Paulus Kirchhof Paulus Kirchhof Andreas Rillig |
| author_facet | Ruben Schleberger Ruben Schleberger Jan Riess Anika Brauer Hans O. Pinnschmidt Laura Rottner Laura Rottner Fabian Moser Julia Moser Shinwan Kany Ilaria My Marc D. Lemoine Marc D. Lemoine Bruno Reissmann Christian Meyer Christian Meyer Andreas Metzner Feifan Ouyang Feifan Ouyang Paulus Kirchhof Paulus Kirchhof Andreas Rillig |
| author_sort | Ruben Schleberger |
| collection | DOAJ |
| description | IntroductionCatheter ablation of ventricular arrhythmias emerging from the ventricular outflow tracts and adjacent structures is very effective and considered almost curative in patients without structural heart disease (SHD). Outcomes of patients with SHD undergoing ablation of outflow tract arrhythmias are not known.MethodsConsecutive patients (2019–2021) undergoing catheter ablation of ventricular arrhythmias in a single high-volume center were retrospectively analyzed. Patients with ablation of outflow tract arrhythmias were identified and divided in individuals with and without SHD. Procedural parameters and acute outcome were compared.ResultsWe identified 215 patients with outflow tract arrhythmias (35.3% female, mean age 58.3 ± 16.0 years). Of those, 93 (43.3%) had SHD. Patients with SHD and outflow tract arrhythmias were older (65.0 ± 12.8 vs. 53.3 ± 16.3 years; p < 0.001), more often male (82.8 vs. 50.0%; p < 0.001) and had more comorbidities than patients without SHD (arterial hypertension: 62.4 vs. 34.4%, p < 0.001; diabetes: 22.6 vs. 8.2%, p = 0.005; chronic lung disease: 20.4 vs. 7.4%, p = 0.007). Outflow tract arrhythmias in patients with SHD had their origin more often in the left ventricle (68.8 vs. 53.3%, p = 0.025). The acute success rate was similar in both patient groups (93.4 vs. 94.2%, p = 0.781). Patients with SHD were discharged later {median length of hospital stay with SHD 5 [6 (interquartile range)] days, without SHD 2 [4] days, p < 0.001}. Periprocedural complications were numerically more frequent in patients with SHD [with SHD 12 (12.9%), without SHD 8 (6.6%), p = 0.154].ConclusionOutflow tract arrhythmia ablation has a high success rate irrespective of the presence of SHD. Longer hospital stay and potentially a higher risk of periprocedural complications should be considered when discussing this treatment option with patients. |
| first_indexed | 2024-12-12T09:01:38Z |
| format | Article |
| id | doaj.art-1ef6a173221d41588328d3f1dd6a5004 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-12T09:01:38Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-1ef6a173221d41588328d3f1dd6a50042022-12-22T00:29:49ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-05-01910.3389/fcvm.2022.910042910042Ablation of Outflow Tract Arrhythmias in Patients With and Without Structural Heart Disease—A Comparative AnalysisRuben Schleberger0Ruben Schleberger1Jan Riess2Anika Brauer3Hans O. Pinnschmidt4Laura Rottner5Laura Rottner6Fabian Moser7Julia Moser8Shinwan Kany9Ilaria My10Marc D. Lemoine11Marc D. Lemoine12Bruno Reissmann13Christian Meyer14Christian Meyer15Andreas Metzner16Feifan Ouyang17Feifan Ouyang18Paulus Kirchhof19Paulus Kirchhof20Andreas Rillig21Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Berlin, GermanyDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyInstitute of Medical Biometry and Epidemiology, Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Berlin, GermanyDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Berlin, GermanyDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Cardiology, Cardiac Neuro- and Electrophysiology Research Consortium, Protestant Hospital Düsseldorf, Düsseldorf, GermanyCardiac Neuro- and Electrophysiology Research Consortium, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, GermanyDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyHong Kong Asian Medical Group, Hong Kong, ChinaDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyInstitute of Cardiovascular Sciences, University of Birmingham, Birmingham, United KingdomDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyIntroductionCatheter ablation of ventricular arrhythmias emerging from the ventricular outflow tracts and adjacent structures is very effective and considered almost curative in patients without structural heart disease (SHD). Outcomes of patients with SHD undergoing ablation of outflow tract arrhythmias are not known.MethodsConsecutive patients (2019–2021) undergoing catheter ablation of ventricular arrhythmias in a single high-volume center were retrospectively analyzed. Patients with ablation of outflow tract arrhythmias were identified and divided in individuals with and without SHD. Procedural parameters and acute outcome were compared.ResultsWe identified 215 patients with outflow tract arrhythmias (35.3% female, mean age 58.3 ± 16.0 years). Of those, 93 (43.3%) had SHD. Patients with SHD and outflow tract arrhythmias were older (65.0 ± 12.8 vs. 53.3 ± 16.3 years; p < 0.001), more often male (82.8 vs. 50.0%; p < 0.001) and had more comorbidities than patients without SHD (arterial hypertension: 62.4 vs. 34.4%, p < 0.001; diabetes: 22.6 vs. 8.2%, p = 0.005; chronic lung disease: 20.4 vs. 7.4%, p = 0.007). Outflow tract arrhythmias in patients with SHD had their origin more often in the left ventricle (68.8 vs. 53.3%, p = 0.025). The acute success rate was similar in both patient groups (93.4 vs. 94.2%, p = 0.781). Patients with SHD were discharged later {median length of hospital stay with SHD 5 [6 (interquartile range)] days, without SHD 2 [4] days, p < 0.001}. Periprocedural complications were numerically more frequent in patients with SHD [with SHD 12 (12.9%), without SHD 8 (6.6%), p = 0.154].ConclusionOutflow tract arrhythmia ablation has a high success rate irrespective of the presence of SHD. Longer hospital stay and potentially a higher risk of periprocedural complications should be considered when discussing this treatment option with patients.https://www.frontiersin.org/articles/10.3389/fcvm.2022.910042/fullcatheter ablationoutflow tract arrhythmiaprocedural outcomestructural heart diseaseventricular tachycardiapremature ventricular complexes |
| spellingShingle | Ruben Schleberger Ruben Schleberger Jan Riess Anika Brauer Hans O. Pinnschmidt Laura Rottner Laura Rottner Fabian Moser Julia Moser Shinwan Kany Ilaria My Marc D. Lemoine Marc D. Lemoine Bruno Reissmann Christian Meyer Christian Meyer Andreas Metzner Feifan Ouyang Feifan Ouyang Paulus Kirchhof Paulus Kirchhof Andreas Rillig Ablation of Outflow Tract Arrhythmias in Patients With and Without Structural Heart Disease—A Comparative Analysis Frontiers in Cardiovascular Medicine catheter ablation outflow tract arrhythmia procedural outcome structural heart disease ventricular tachycardia premature ventricular complexes |
| title | Ablation of Outflow Tract Arrhythmias in Patients With and Without Structural Heart Disease—A Comparative Analysis |
| title_full | Ablation of Outflow Tract Arrhythmias in Patients With and Without Structural Heart Disease—A Comparative Analysis |
| title_fullStr | Ablation of Outflow Tract Arrhythmias in Patients With and Without Structural Heart Disease—A Comparative Analysis |
| title_full_unstemmed | Ablation of Outflow Tract Arrhythmias in Patients With and Without Structural Heart Disease—A Comparative Analysis |
| title_short | Ablation of Outflow Tract Arrhythmias in Patients With and Without Structural Heart Disease—A Comparative Analysis |
| title_sort | ablation of outflow tract arrhythmias in patients with and without structural heart disease a comparative analysis |
| topic | catheter ablation outflow tract arrhythmia procedural outcome structural heart disease ventricular tachycardia premature ventricular complexes |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.910042/full |
| work_keys_str_mv | AT rubenschleberger ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT rubenschleberger ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT janriess ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT anikabrauer ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT hansopinnschmidt ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT laurarottner ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT laurarottner ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT fabianmoser ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT juliamoser ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT shinwankany ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT ilariamy ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT marcdlemoine ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT marcdlemoine ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT brunoreissmann ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT christianmeyer ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT christianmeyer ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT andreasmetzner ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT feifanouyang ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT feifanouyang ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT pauluskirchhof ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT pauluskirchhof ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis AT andreasrillig ablationofoutflowtractarrhythmiasinpatientswithandwithoutstructuralheartdiseaseacomparativeanalysis |