Radiofrequency catheter ablation of ventricular arrhythmias in patients with hypertrophic cardiomyopathy: safety and feasibility

被引：62

作者：

Santangeli, Pasquale ^{[1
,5
,6
,7
]}

Di Biase, Luigi ^{[1
,2
,3
]}

Lakkireddy, Dhanunjay ^{[4
]}

Burkhardt, J. David ^{[1
]}

Pillarisetti, Jayasree ^{[4
]}

Michowitz, Yoav ^{[6
,7
]}

Sanchez, Javier E. ^{[1
]}

Horton, Rodney ^{[1
,2
]}

Mohanty, Prasant ^{[1
]}

Gallinghouse, G. Joseph ^{[1
]}

Dello Russo, Antonio ^{[5
]}

Casella, Michela ^{[5
]}

Pelargonio, Gemma ^{[5
]}

Santarelli, Pietro ^{[5
]}

Verma, Atul ^{[8
]}

Narasimhan, Calambur

Shivkumar, Kalyanam ^{[6
,7
]}

Natale, Andrea ^{[1
,2
,9
]}

机构：

[1] St Davids Med Ctr, Texas Cardiac Arrhythmia Inst, Austin, TX 78705 USA

[2] Univ Texas Austin, Dept Biomed Engn, Austin, TX 78712 USA

[3] Univ Foggia, Dept Cardiol, Foggia, Italy

[4] Univ Kansas, Kansas City, KS USA

[5] Catholic Univ, Rome, Italy

[6] Univ Calif Los Angeles, Cardiac Arrhythmia Ctr, Los Angeles, CA USA

[7] Electrophysiol Programs, Los Angeles, CA USA

[8] Southlake Reg Hlth Ctr, New Market, ON, Canada

[9] Stanford Univ, Palo Alto, CA 94304 USA

来源：

HEART RHYTHM | 2010年 / 7卷 / 08期

关键词：

Hypertrophic cardiomyopathy; Ventricular tachycardia; Catheter ablation; Outcomes; IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS; MUSCLE CELL DISORGANIZATION; CARDIAC MAGNETIC-RESONANCE; SUDDEN-DEATH; CLINICAL-MANIFESTATIONS; QUANTITATIVE-ANALYSIS; HEART-DISEASE; TACHYCARDIA; PATHOPHYSIOLOGY; INTERRELATIONS;

D O I：

10.1016/j.hrthm.2010.05.022

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Management of ventricular tachycardia (VT) in patients with hypertrophic cardiomyopathy (HCM) is challenging. OBJECTIVE The purpose of this study is to assess the value of radiofrequency catheter ablation (RFCA) for the treatment of the VTs in the setting of HCM. METHODS Twenty-two patients (18 with ICD) with HCM and multiple episodes of VTs resistant to medical therapy underwent RFCA with an open irrigation catheter. Epicardial access was obtained if required. All patients were followed for at least 1 year after RFCA. RESULTS Mean age was 50.4 +/- 15.3, and mean ejection fraction was 34.3% +/- 9.8%. RFCA was performed endocardially in all patients, while epicardial radiofrequency applications were needed in 13 patients. A previous endocardial ablation was unsuccessful in six patients. At 20 +/- 9 months of follow-up, elimination of VTs reached 73%. No major complication was observed during and after the procedures in all patients. CONCLUSION Catheter ablation of VTs in patients with hypertrophic cardiomyopathy refractory to medical therapy is safe, feasible, and successful in eliminating VT. Epicardial VT mapping and ablation should be considered as an important access option for the treatment of these patients to increase the success rate.

引用

页码：1036 / 1042

页数：7

共 33 条

[1] Occurrence and frequency of arrhythmias in hypertrophic cardiomyopathy on relation to delayed enhancement on cardiovascular magnetic resonance [J].