AI Article Synopsis
- A study on arrhythmogenic right ventricular cardiomyopathy (ARVC) found that a significant number of patients (34%) experienced atrial arrhythmias (AAs) even after undergoing ventricular tachycardia (VT) ablation.
- The most common types of AAs were atrial fibrillation, typical atrial flutter, and atypical flutter, with many patients requiring further ablation procedures to manage these issues effectively.
- A risk score was developed to predict the likelihood of typical atrial flutter, which can help identify patients who might benefit from specific interventions during VT ablation.
Article Abstract
Background: In arrhythmogenic right ventricular cardiomyopathy (ARVC), risk of atrial arrhythmias (AAs) persists after ventricular tachycardia (VT) ablation.
Objective: The purpose of this study was to determine the type, prevalence, outcome, and risk correlates of AA in ARVC in patients undergoing VT ablation.
Methods: Prospectively collected procedural and clinical data on ARVC patients undergoing VT ablation were analyzed. Risk score for typical atrial flutter was determined from univariate logistic regression analysis.
Results: Of 119 consecutive patients with ARVC and VT ablation, 40 (34%) had AA: atrial fibrillation (AF) in 31, typical isthmus-dependent atrial flutter (AFL) in 27, and atrial tachycardia/atypical flutter (AT) in 10. Seventeen patients (43%) with AA experienced inappropriate defibrillator therapy, with 15 patients experiencing shocks. Ablation was performed for typical AFL in 21 (53%), AT in 5 (13%), and pulmonary vein isolation for AF in 4 (10%) patients and prevented AA in 78% and all AFL during additional mean follow-up of 65 months. Risk score for typical flutter included age >40 years (1 point), ≥moderate right ventricular dysfunction (2 points), ≥moderate tricuspid regurgitation (2 points), ≥moderate right atrial dilation (2 points), and right ventricular volume >250 cc (3points), with score >4 identifying 50% prevalence of typical flutter.
Conclusion: AAs are common in patients with ARVC and VT, can result in inappropriate implantable cardioverter-defibrillator shocks, and typically are controlled with atrial ablation. A risk score can be used to identify patients at high risk for typical AFL who may be considered for isthmus ablation at the time of VT ablation.
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| http://dx.doi.org/10.1016/j.hrthm.2023.11.005 | DOI Listing |
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