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Long-Term Follow-Up of Catheter Ablation for Premature Ventricular Complexes in the Modern Era: The Importance of Localization and Substrate
Background: Large-scale studies evaluating long-term recurrence rates in both idiopathic and non-idiopathic PVC catheter ablation (CA) patients have not been reported. Objective: To evaluate the efficacy and safety of idiopathic and non-idiopathic PVC CA, investigating the predictors of acute and lo...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9654324/ https://www.ncbi.nlm.nih.gov/pubmed/36362811 http://dx.doi.org/10.3390/jcm11216583 |
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author | Gulletta, Simone Gasperetti, Alessio Schiavone, Marco Paglino, Gabriele Vergara, Pasquale Compagnucci, Paolo Bisceglia, Caterina Cireddu, Manuela Fierro, Nicolai D’Angelo, Giuseppe Sala, Simone Rampa, Lorenzo Casella, Michela Mazzone, Patrizio Dello Russo, Antonio Forleo, Giovanni Battista Della Bella, Paolo |
author_facet | Gulletta, Simone Gasperetti, Alessio Schiavone, Marco Paglino, Gabriele Vergara, Pasquale Compagnucci, Paolo Bisceglia, Caterina Cireddu, Manuela Fierro, Nicolai D’Angelo, Giuseppe Sala, Simone Rampa, Lorenzo Casella, Michela Mazzone, Patrizio Dello Russo, Antonio Forleo, Giovanni Battista Della Bella, Paolo |
author_sort | Gulletta, Simone |
collection | PubMed |
description | Background: Large-scale studies evaluating long-term recurrence rates in both idiopathic and non-idiopathic PVC catheter ablation (CA) patients have not been reported. Objective: To evaluate the efficacy and safety of idiopathic and non-idiopathic PVC CA, investigating the predictors of acute and long-term efficacy. Methods: This retrospective multicentric study included 439 patients who underwent PVC CA at three institutions from April-2015 to December-2021. Clinical success at 6 months’ follow-up, defined as a reduction of at least 80% of the pre-procedural PVC burden, was deemed the primary outcome. The secondary aims of the study were: clinical success at the last available follow-up, predictors of arrhythmic recurrences at long-term follow-up, and safety outcomes. Results: The median age was 51 years, with 24.9% patients being affected suffering from structural heart disease. The median pre-procedural PVC burden was 20.1%. PVCs originating from the RVOT were the most common index PVC observed (29.1%), followed by coronary cusp (CC) and non-outflow tract (OT) LV PVCs (23.1% and 19.0%). The primary outcome at 6 months was reached in 85.1% cases, with a significant reduction in the 24 h% PVC burden (−91.4% [−83.4; −96.7], p < 0.001); long-term efficacy was observed in 82.1% of cases at almost 3-year follow-up. The presence of underlying structural heart disease and non-OT LV region origin (aHR 1.77 [1.07–2.93], p = 0.027 and aHR = 1.96 [1.22–3.14], p = 0.005) was independently associated with recurrences. Conclusion: CA of both idiopathic and non-idiopathic PVCs showed a very good acute and long-term procedural success rate, with an overall low complication. Predictors of arrhythmic recurrence at follow-up were underlying structural heart disease and non-OT LV origin. |
format | Online Article Text |
id | pubmed-9654324 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96543242022-11-15 Long-Term Follow-Up of Catheter Ablation for Premature Ventricular Complexes in the Modern Era: The Importance of Localization and Substrate Gulletta, Simone Gasperetti, Alessio Schiavone, Marco Paglino, Gabriele Vergara, Pasquale Compagnucci, Paolo Bisceglia, Caterina Cireddu, Manuela Fierro, Nicolai D’Angelo, Giuseppe Sala, Simone Rampa, Lorenzo Casella, Michela Mazzone, Patrizio Dello Russo, Antonio Forleo, Giovanni Battista Della Bella, Paolo J Clin Med Article Background: Large-scale studies evaluating long-term recurrence rates in both idiopathic and non-idiopathic PVC catheter ablation (CA) patients have not been reported. Objective: To evaluate the efficacy and safety of idiopathic and non-idiopathic PVC CA, investigating the predictors of acute and long-term efficacy. Methods: This retrospective multicentric study included 439 patients who underwent PVC CA at three institutions from April-2015 to December-2021. Clinical success at 6 months’ follow-up, defined as a reduction of at least 80% of the pre-procedural PVC burden, was deemed the primary outcome. The secondary aims of the study were: clinical success at the last available follow-up, predictors of arrhythmic recurrences at long-term follow-up, and safety outcomes. Results: The median age was 51 years, with 24.9% patients being affected suffering from structural heart disease. The median pre-procedural PVC burden was 20.1%. PVCs originating from the RVOT were the most common index PVC observed (29.1%), followed by coronary cusp (CC) and non-outflow tract (OT) LV PVCs (23.1% and 19.0%). The primary outcome at 6 months was reached in 85.1% cases, with a significant reduction in the 24 h% PVC burden (−91.4% [−83.4; −96.7], p < 0.001); long-term efficacy was observed in 82.1% of cases at almost 3-year follow-up. The presence of underlying structural heart disease and non-OT LV region origin (aHR 1.77 [1.07–2.93], p = 0.027 and aHR = 1.96 [1.22–3.14], p = 0.005) was independently associated with recurrences. Conclusion: CA of both idiopathic and non-idiopathic PVCs showed a very good acute and long-term procedural success rate, with an overall low complication. Predictors of arrhythmic recurrence at follow-up were underlying structural heart disease and non-OT LV origin. MDPI 2022-11-06 /pmc/articles/PMC9654324/ /pubmed/36362811 http://dx.doi.org/10.3390/jcm11216583 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Gulletta, Simone Gasperetti, Alessio Schiavone, Marco Paglino, Gabriele Vergara, Pasquale Compagnucci, Paolo Bisceglia, Caterina Cireddu, Manuela Fierro, Nicolai D’Angelo, Giuseppe Sala, Simone Rampa, Lorenzo Casella, Michela Mazzone, Patrizio Dello Russo, Antonio Forleo, Giovanni Battista Della Bella, Paolo Long-Term Follow-Up of Catheter Ablation for Premature Ventricular Complexes in the Modern Era: The Importance of Localization and Substrate |
title | Long-Term Follow-Up of Catheter Ablation for Premature Ventricular Complexes in the Modern Era: The Importance of Localization and Substrate |
title_full | Long-Term Follow-Up of Catheter Ablation for Premature Ventricular Complexes in the Modern Era: The Importance of Localization and Substrate |
title_fullStr | Long-Term Follow-Up of Catheter Ablation for Premature Ventricular Complexes in the Modern Era: The Importance of Localization and Substrate |
title_full_unstemmed | Long-Term Follow-Up of Catheter Ablation for Premature Ventricular Complexes in the Modern Era: The Importance of Localization and Substrate |
title_short | Long-Term Follow-Up of Catheter Ablation for Premature Ventricular Complexes in the Modern Era: The Importance of Localization and Substrate |
title_sort | long-term follow-up of catheter ablation for premature ventricular complexes in the modern era: the importance of localization and substrate |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9654324/ https://www.ncbi.nlm.nih.gov/pubmed/36362811 http://dx.doi.org/10.3390/jcm11216583 |
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