Electrophysiological characteristics and radiofrequency ablation of sustained monomorphic ventricular tachycardia in adult patients with isolated ventricular noncompaction

  • Yanhui Li
  • Yumei Xue
  • Jianhua Yu
  • Chenyang Jiang
  • Zulu Wang
  • Mackenzi Mbai
  • Venkatakrishna Tholakanahalli
  • David G Benditt
  • Jian-Ming Li
Article
  • 49 Downloads

Abstracts

Purpose

This study examined electrophysiological characteristics and outcomes of patients with sustained ventricular tachycardia (VT) in the setting of isolated ventricular noncompaction (IVNC).

Background

In patients with IVNC, VT has been associated with sudden cardiac death. However, the electrophysiological characteristics and optimal management of these VTs are only incompletely understood.

Methods

This retrospective cohort study assessed arrhythmia characteristics and outcomes in IVNC patients with sustained monomorphic VTs. Data were obtained from five academic centers covering the time period from January 1, 2006, to December 31, 2016, with a median follow-up of 40 months.

Results

Eighteen consecutive IVNC patients with sustained VTs (12 males [66%], mean age of 44.4 ± 16.9 years) were enrolled. Seven (39%) patients underwent VT ablation (five males, mean age of 43.3 ± 15.5 years) and nine (50%) patients received ICD therapy. Six of 18 patients (33%) died during a median follow-up of 40 months. Of these, three had ICDs, two had undergone VT ablation, and one had received only antiarrhythmic drugs. Among the seven patients with prior VT ablation, five VTs in the RV (three RVOT and one tricuspid annulus) and two LV VTs (one anterolateral papillary muscle and one inferolateral wall) were localized by 3-D mapping and successfully ablated. In six of seven ablation cases (85.7%), the VTs were distant from the noncompaction zone. VTs appeared to be focal in 57% (4/7) and macro-reentry in 43% (3/7) of patients based on 3-D mapping and entrainment studies. The success rate of VT ablation was 85.7% with one VT recurrence and two deaths during the mean follow-up of 54 (28–115) months.

Conclusions

IVNC Patients with sustained VTs appear to have a poor prognosis despite receiving ICD or apparently successful VT ablation therapy. Further, most VTs appear to arise remote from the noncompaction zone. Whether these VTs were “idiopathic” or related to IVNC was uncertain.

Keywords

Noncompaction Ventricular tachycardia Electroanatomical mapping Catheter ablation Cardiomyopathy 

Notes

Compliance with ethical standards

Disclosures

The authors declare no commercial associations or sources of support that might pose a conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Clinical MedicineTsinghua UniversityBeijingPeople’s Republic of China
  2. 2.Division of CardiologyMinneapolis Veterans Affairs Medical CenterMinneapolisUSA
  3. 3.Cardiovascular DivisionUniversity of Minnesota Medical SchoolMinneapolisUSA
  4. 4.Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Academy of Medical SciencesGuangdong General HospitalGuangzhou ShiPeople’s Republic of China
  5. 5.Department of Cardiovascular MedicineThe Second Affiliated Hospital of Nanchang UniversityNanchangPeople’s Republic of China
  6. 6.Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhouPeople’s Republic of China
  7. 7.Department of Cardiologythe General Hospital of Shenyang Military RegionShenyangPeople’s Republic of China
  8. 8.VA Medical CenterMinneapolisUSA

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