AI Article Synopsis
- - This study investigates the long-term effects of ablation treatment in young patients with bundle branch reentrant ventricular tachycardia (BBRT) who do not have structural heart disease (SHD)
- It involved 11 patients with a median follow-up of 72 months, revealing significant increases in PR interval and QRS duration, indicating worsening heart conduction
- Genetic testing found potential pathogenic variants in 6 out of 10 patients, suggesting a genetic predisposition may contribute to the observed clinical deterioration in the His-Purkinje system.
Article Abstract
Background: Ablation strategies to treat bundle branch reentrant ventricular tachycardia (BBRT) are well described. However, reports of long-term follow-up outcomes in BBRT patients without structural heart disease (SHD) are limited.
Objective: The purpose of this study was to investigate the long-term follow-up prognosis of BBRT patients without SHD.
Methods: Changes in electrocardiographic and echocardiographic parameters were used to evaluate progression during follow-up. Potential pathogenic candidate variants were screened using a specific gene panel.
Results: Eleven consecutive BBRT patients without obvious SHD based on echocardiographic and cardiovascular magnetic resonance imaging results were enrolled. Median age was 20 (11-48) years, and median follow-up time was 72 months. During follow-up, PR interval [206 (158-360) ms vs 188 (158-300) ms; P = .018] and QRS duration [187 (155-240) ms vs 164 (130-178) ms; P = .008] each increased significantly compared with postablation. Right- and left-sided chamber dilation and reduced left ventricular ejection fraction (LVEF) also were observed. Clinical deterioration or events occurred in 8 patients: 1 sudden death; 3 both complete heart block and reduced LVEF; 2 significantly reduced LVEF; and 2 prolonged PR interval. Genetic testing results showed that 6 of 10 patients (excluding the patient with sudden death) had ≥1 potential pathogenic candidate variants.
Conclusion: Further deterioration of His-Purkinje system conduction was observed in young BBRT patients without SHD after ablation. The His-Purkinje system may be the first target of genetic predisposition.
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| http://dx.doi.org/10.1016/j.hrthm.2023.02.027 | DOI Listing |
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