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Gasperetti A, James CA, Chen L, Schenker N, Casella M, Kany S, Mathew S, Compagnucci P, Müssigbrodt A, Jensen HK, Svensson A, Costa S, Forleo GB, Platonov PG, Tondo C, Song JP, Dello Russo A, Ruschitzka F, Brunckhorst C, Calkins H, Duru F, Saguner AM. Efficacy of Catheter Ablation for Atrial Arrhythmias in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy-A Multicenter Study. J Clin Med 2021; 10:jcm10214962. [PMID: 34768482 PMCID: PMC8584554 DOI: 10.3390/jcm10214962] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Atrial arrhythmias are present in up to 20% of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). Catheter ablation (CA) is an effective treatment for atrial arrhythmias in the general population. Data regarding CA for atrial arrhythmias in ARVC are scarce. Objective: To assess the safety and efficacy of CA for atrial arrhythmias in patients with ARVC. Methods: In this international collaborative effort, all patients with a definite diagnosis of ARVC undergoing CA for atrial fibrillation (AF), focal atrial tachycardia (AT), or cavotricuspid isthmus (CTI)-dependent atrial flutter (AFl) were extracted from twelve ARVC registries. Demographic, periprocedural, and long-term arrhythmic outcome data were collected. Results: Thirty-seven patients were enrolled in the study (age 50.2 ± 16.6 years, male 84%, CHA2DS2VASc 1 (1,2), HAS-BLED 0 (0–2)). The arrhythmia leading to CA was AF in 23 (62%), focal left AT in 5 (14%), and CTI-dependent AFl in 9 (24%). Acute procedural success was achieved in all procedures but one (n = 1 focal left AT; 97% acute success). The median follow-up period was 27 (13–67) months, and 96%, 74%, and 61% of patients undergoing AF ablation were free from any atrial arrhythmia recurrence after a single procedure at 6 months, 12 months, and last follow-up, respectively. After focal AT ablation, freedom from atrial arrhythmia recurrence was 80%, 80%, and 60% at 6 months, 12 months, and last follow-up, respectively. All patients undergoing CTI ablation were free from atrial arrhythmia recurrences at 6 months, with 89% single-procedural arrhythmic freedom at last follow-up. One major complication (2.7%; PV stenosis requiring PV stenting) occurred. Conclusions: CA is safe and effective in managing atrial arrhythmias in patients with ARVC, with success rates comparable to the general population.
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Affiliation(s)
- Alessio Gasperetti
- Department of Cardiology, University Heart Center, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland; (S.C.); (F.R.); (C.B.); (F.D.); (A.M.S.)
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I—Lancisi—Salesi”, 60126 Ancona, Italy; (M.C.); (P.C.); (A.D.R.)
- Department of Biomedical Science and Public Health, Marche Polytechnic University, 60126 Ancona, Italy
- Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD 21205, USA; (C.A.J.); (H.C.)
- Correspondence:
| | - Cynthia A. James
- Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD 21205, USA; (C.A.J.); (H.C.)
| | - Liang Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College, Beijing 100000, China; (L.C.); (J.-P.S.)
| | - Niklas Schenker
- Department of Cardiology, Asklepios Klinik St. Georg Hamburg, 20099 Hamburg, Germany; (N.S.); (S.M.)
| | - Michela Casella
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I—Lancisi—Salesi”, 60126 Ancona, Italy; (M.C.); (P.C.); (A.D.R.)
- Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy
| | - Shinwan Kany
- Department of Cardiology, University Heart and Vascular Centre Hamburg, University Medical Centre Hamburg-Eppendorf, 20251 Hamburg, Germany;
| | - Shibu Mathew
- Department of Cardiology, Asklepios Klinik St. Georg Hamburg, 20099 Hamburg, Germany; (N.S.); (S.M.)
| | - Paolo Compagnucci
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I—Lancisi—Salesi”, 60126 Ancona, Italy; (M.C.); (P.C.); (A.D.R.)
- Department of Biomedical Science and Public Health, Marche Polytechnic University, 60126 Ancona, Italy
| | - Andreas Müssigbrodt
- Department of Electrophysiology, Heart Center University of Leipzig, 04289 Leipzig, Germany;
- Department of Cardiology, University Hospital of Martinique, 97200 Fort de France, Martinique, France
| | - Henrik K. Jensen
- Department of Cardiology, Aarhus University Hospital, 8200 Aarhus, Denmark;
- Department of Clinical Medicine, Health, Aarhus University, 8200 Aarhus, Denmark
| | - Anneli Svensson
- Department of Cardiology, Linköping University, 58183 Linköping, Sweden;
- Department of Medical and Health Sciences, Linköping University, 58183 Linköping, Sweden
| | - Sarah Costa
- Department of Cardiology, University Heart Center, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland; (S.C.); (F.R.); (C.B.); (F.D.); (A.M.S.)
| | | | - Pyotr G. Platonov
- Lund University Arrhythmia Clinic, Department of Cardiology, Skåne University Hospital, 22185 Lund, Sweden;
| | - Claudio Tondo
- Heart Rhythm Center, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy;
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Jiang-Ping Song
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College, Beijing 100000, China; (L.C.); (J.-P.S.)
| | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I—Lancisi—Salesi”, 60126 Ancona, Italy; (M.C.); (P.C.); (A.D.R.)
- Department of Biomedical Science and Public Health, Marche Polytechnic University, 60126 Ancona, Italy
| | - Frank Ruschitzka
- Department of Cardiology, University Heart Center, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland; (S.C.); (F.R.); (C.B.); (F.D.); (A.M.S.)
| | - Corinna Brunckhorst
- Department of Cardiology, University Heart Center, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland; (S.C.); (F.R.); (C.B.); (F.D.); (A.M.S.)
| | - Hugh Calkins
- Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD 21205, USA; (C.A.J.); (H.C.)
| | - Firat Duru
- Department of Cardiology, University Heart Center, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland; (S.C.); (F.R.); (C.B.); (F.D.); (A.M.S.)
| | - Ardan M. Saguner
- Department of Cardiology, University Heart Center, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland; (S.C.); (F.R.); (C.B.); (F.D.); (A.M.S.)
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