Ashish Sood MBBS, Samual Turnbull BSc, Kasun De Silva MBBS, Ashwin Bhaskaran MBBS, MSc (Int Med), Richard G. Bennett BSc, MBChB, PhD, Timothy G. Campbell BSc, PhD, Liza Thomas MBBS, PhD, Saurabh Kumar MBBS, PhD
{"title":"导管消融治疗室性心动过速对结构性心脏病患者左室射血分数的影响","authors":"Ashish Sood MBBS, Samual Turnbull BSc, Kasun De Silva MBBS, Ashwin Bhaskaran MBBS, MSc (Int Med), Richard G. Bennett BSc, MBChB, PhD, Timothy G. Campbell BSc, PhD, Liza Thomas MBBS, PhD, Saurabh Kumar MBBS, PhD","doi":"10.1002/joa3.70042","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Catheter ablation (CA) is efficacious for the treatment of ventricular tachycardia (VT) in patients with structural heart disease; however, heart failure contributes to long-term mortality in this cohort. Whether CA worsens left ventricular function requires investigation.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We retrospectively analyzed 142 consecutive patients with structural heart disease undergoing CA for VT. Pre-ablation left ventricular ejection fraction (LVEF) was compared to LVEF postablation, predictors of change in LVEF were identified, and the relationship between change in LVEF and arrhythmic recurrence was assessed.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Patients with ischemic cardiomyopathy (ICM) had lower pre-ablation LVEF than patients with non-ischemic cardiomyopathy (NICM) (36.2 ± 14.3% vs. 50.8 ± 12.8%, <i>p</i> < 0.001). There was no statistically significant change in LVEF following ablation for patients with ICM (<i>p</i> = 0.45) or NICM (<i>p</i> = 0.75). Patients with pre-ablation LVEF ≤20% experienced the largest recovery in LVEF, mean recovery 5.3% (95% CI: 0.6–10.1), <i>p</i> = 0.03, with LVEF recovery postablation similar in ICM and NICM patients (<i>p</i> = 0.69). Recovery of LVEF was associated with a decreased incidence of ventricular arrhythmia (VA) recurrence (<i>p</i> = 0.03) and an increased VA-recurrence-free survival (<i>p</i> = 0.04).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>CA for VT does not cause a decline in LVEF among patients with structural heart disease. The subset of patients with severely impaired LVEF may experience an increase in LVEF following ablation and an associated reduction in VA recurrence.</p>\n </section>\n </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70042","citationCount":"0","resultStr":"{\"title\":\"Impact of catheter ablation for ventricular tachycardia on left ventricular ejection fraction in patients with structural heart disease\",\"authors\":\"Ashish Sood MBBS, Samual Turnbull BSc, Kasun De Silva MBBS, Ashwin Bhaskaran MBBS, MSc (Int Med), Richard G. Bennett BSc, MBChB, PhD, Timothy G. Campbell BSc, PhD, Liza Thomas MBBS, PhD, Saurabh Kumar MBBS, PhD\",\"doi\":\"10.1002/joa3.70042\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Catheter ablation (CA) is efficacious for the treatment of ventricular tachycardia (VT) in patients with structural heart disease; however, heart failure contributes to long-term mortality in this cohort. Whether CA worsens left ventricular function requires investigation.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We retrospectively analyzed 142 consecutive patients with structural heart disease undergoing CA for VT. Pre-ablation left ventricular ejection fraction (LVEF) was compared to LVEF postablation, predictors of change in LVEF were identified, and the relationship between change in LVEF and arrhythmic recurrence was assessed.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Patients with ischemic cardiomyopathy (ICM) had lower pre-ablation LVEF than patients with non-ischemic cardiomyopathy (NICM) (36.2 ± 14.3% vs. 50.8 ± 12.8%, <i>p</i> < 0.001). There was no statistically significant change in LVEF following ablation for patients with ICM (<i>p</i> = 0.45) or NICM (<i>p</i> = 0.75). Patients with pre-ablation LVEF ≤20% experienced the largest recovery in LVEF, mean recovery 5.3% (95% CI: 0.6–10.1), <i>p</i> = 0.03, with LVEF recovery postablation similar in ICM and NICM patients (<i>p</i> = 0.69). Recovery of LVEF was associated with a decreased incidence of ventricular arrhythmia (VA) recurrence (<i>p</i> = 0.03) and an increased VA-recurrence-free survival (<i>p</i> = 0.04).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>CA for VT does not cause a decline in LVEF among patients with structural heart disease. The subset of patients with severely impaired LVEF may experience an increase in LVEF following ablation and an associated reduction in VA recurrence.</p>\\n </section>\\n </div>\",\"PeriodicalId\":15174,\"journal\":{\"name\":\"Journal of Arrhythmia\",\"volume\":\"41 2\",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-03-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70042\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Arrhythmia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/joa3.70042\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Arrhythmia","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/joa3.70042","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Impact of catheter ablation for ventricular tachycardia on left ventricular ejection fraction in patients with structural heart disease
Background
Catheter ablation (CA) is efficacious for the treatment of ventricular tachycardia (VT) in patients with structural heart disease; however, heart failure contributes to long-term mortality in this cohort. Whether CA worsens left ventricular function requires investigation.
Methods
We retrospectively analyzed 142 consecutive patients with structural heart disease undergoing CA for VT. Pre-ablation left ventricular ejection fraction (LVEF) was compared to LVEF postablation, predictors of change in LVEF were identified, and the relationship between change in LVEF and arrhythmic recurrence was assessed.
Results
Patients with ischemic cardiomyopathy (ICM) had lower pre-ablation LVEF than patients with non-ischemic cardiomyopathy (NICM) (36.2 ± 14.3% vs. 50.8 ± 12.8%, p < 0.001). There was no statistically significant change in LVEF following ablation for patients with ICM (p = 0.45) or NICM (p = 0.75). Patients with pre-ablation LVEF ≤20% experienced the largest recovery in LVEF, mean recovery 5.3% (95% CI: 0.6–10.1), p = 0.03, with LVEF recovery postablation similar in ICM and NICM patients (p = 0.69). Recovery of LVEF was associated with a decreased incidence of ventricular arrhythmia (VA) recurrence (p = 0.03) and an increased VA-recurrence-free survival (p = 0.04).
Conclusion
CA for VT does not cause a decline in LVEF among patients with structural heart disease. The subset of patients with severely impaired LVEF may experience an increase in LVEF following ablation and an associated reduction in VA recurrence.
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