Influence of myocardial scar on the response to frequent premature ventricular complex ablation

Objective This study aims to evaluate the influence of myocardial scar after premature ventricular complexes (PVC) ablation in patients with left ventricular (LV) dysfunction. Methods 70 consecutive patients (58±11 years, 58 (83%) men, 23% (18–32) mean PVC burden) with LV dysfunction and frequent PV...

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Detalhes bibliográficos
Autores: Penela, Diego, Martinez, Mikel, Fernández Armenta, Juan, Aguinaga, Luis, Tercedor, Luis, Ordóñez, Augusto, Acosta, Juan, Martí Almor, Julio, Bisbal, Felipe, Rossi, Luca, Borràs, Roger, Linhart, Markus, Soto Iglesias, David, Jáuregui Garrido, Beatriz, Ortiz Pérez, José Tomás, Perea Palazón, Rosario Jesús, Bosch Genover, Xavier, Mont Girbau, Lluís, Berruezo Sánchez, Antonio
Formato: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2019
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/225205
Acesso em linha:https://hdl.handle.net/2445/225205
Access Level:acceso abierto
Palavra-chave:Infart de miocardi
Ablació percutània
Ventricles cardíacs
Myocardial infarction
Catheter ablation
Ventricle of heart
Descrição
Resumo:Objective This study aims to evaluate the influence of myocardial scar after premature ventricular complexes (PVC) ablation in patients with left ventricular (LV) dysfunction. Methods 70 consecutive patients (58±11 years, 58 (83%) men, 23% (18–32) mean PVC burden) with LV dysfunction and frequent PVCs submitted for ablation were included. A late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) was performed prior to the ablation and a quantitative and qualitative analysis of the scar was done. Results Left ventricular ejection fraction progressively improved from 34.3%±9% at baseline to 44.4%±12% at 12 months (p<0.01) and 48 (69%) patients were echocardiographic responders. New York Heart Association class improved from 1.96±0.9 points at baseline to 1.36±0.6 at 12 months (p<0.001). Brain natriuretic peptide decreased from 120 (60–284) to 46 (23–81) pg/mL (p=0.04). Twenty-nine (41%) patients showed scar in the preprocedural LGE-CMR with a mean scar mass of 10.4 (5–20) g. Mean scar mass was significantly smaller in responders than in non-responders (0 (0–4.7) g vs 2 (0–14) g, respectively, p=0.017). PVC burden reduction (OR 1.09 (1.01–1.16), p=0.02) and scar mass (OR 0.9 (0.81–0.99), p=0.04) were independent predictors of response, but the former showed a higher accuracy. Conclusions Presence of myocardial scar modulates, but does not preclude, the probability of response to PVC ablation in patients with LV dysfunction.

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