Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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
_version_ 1784828902327189504
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
work_keys_str_mv AT gullettasimone longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT gasperettialessio longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT schiavonemarco longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT paglinogabriele longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT vergarapasquale longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT compagnuccipaolo longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT biscegliacaterina longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT cireddumanuela longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT fierronicolai longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT dangelogiuseppe longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT salasimone longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT rampalorenzo longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT casellamichela longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT mazzonepatrizio longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT dellorussoantonio longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT forleogiovannibattista longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate
AT dellabellapaolo longtermfollowupofcatheterablationforprematureventricularcomplexesinthemoderneratheimportanceoflocalizationandsubstrate