Decennial follow-up in patients with recurrent tachycardia originating from the right ventricular outflow tract: electrophysiologic characteristics and response to treatment

TY - JOUR

T1 - Decennial follow-up in patients with recurrent tachycardia originating from the right ventricular outflow tract: electrophysiologic characteristics and response to treatment

AU - Ventura, Rodolfo

AU - Steven, Daniel

AU - Klemm, Hanno U

AU - Lutomsky, Boris

AU - Müllerleile, Kai

AU - Rostock, Thomas

AU - Servatius, Helge

AU - Risius, Tim

AU - Meinertz, Thomas

AU - Kuck, Karl-Heinz

AU - Willems, Stephan

PY - 2007/10

Y1 - 2007/10

N2 - AIMS: In the setting of right ventricular outflow tract-tachycardia (RVOT-T), data about long-term follow-up (FU) with respect to the therapeutic strategies are missing. All patients (pts) referred to our institution during the last 20 years for the treatment of RVOT-T were studied in a retrospective analysis to assess mortality and efficacy of treatment.METHODS AND RESULTS: One hundred and thirty-three patients (77 female; 39+/-13 years) with sustained RVOT-T were included in this study. At the time of first presentation, diagnosis of RVOT-T was made by complete invasive and non-invasive diagnostic assessment, including electrophysiology study and two-dimensional echocardiography. After 135+/-68 months (median 136, range 29-248), patients were invited to undergo clinical assessment. Of the 133 pts, 127 (95%) survived and six (5%) died from non-cardiac disease. Anti-arrhythmic (AA) drugs were given to 62 of the 133 pts (47%); of them 32 (52%) had recurrences during follow-up. The mean time to recurrence was 10.02 years (95% CI 7.46-12.59). The other 71 study patients (53%) underwent catheter ablation. The procedure was successful in 58 pts (82%). During follow-up, 30 (52%) of the 58 successfully treated patients had recurrences of RVOT-T. The mean time to recurrence was 6.28 years (95% CI 4.96-7.6). RVOT-T recurrences were similar in morphology to those treated previously in 33% and different in 67% of cases.CONCLUSIONS: Long-term follow-up in patients with RVOT-T is favourable. Catheter ablation is effective in this setting. However, late recurrences with similar or different morphology may arise in half of the patients after initially successful treatment. AA drug therapy is a valid initial therapeutic option, since it is effective in about half of the patients.

AB - AIMS: In the setting of right ventricular outflow tract-tachycardia (RVOT-T), data about long-term follow-up (FU) with respect to the therapeutic strategies are missing. All patients (pts) referred to our institution during the last 20 years for the treatment of RVOT-T were studied in a retrospective analysis to assess mortality and efficacy of treatment.METHODS AND RESULTS: One hundred and thirty-three patients (77 female; 39+/-13 years) with sustained RVOT-T were included in this study. At the time of first presentation, diagnosis of RVOT-T was made by complete invasive and non-invasive diagnostic assessment, including electrophysiology study and two-dimensional echocardiography. After 135+/-68 months (median 136, range 29-248), patients were invited to undergo clinical assessment. Of the 133 pts, 127 (95%) survived and six (5%) died from non-cardiac disease. Anti-arrhythmic (AA) drugs were given to 62 of the 133 pts (47%); of them 32 (52%) had recurrences during follow-up. The mean time to recurrence was 10.02 years (95% CI 7.46-12.59). The other 71 study patients (53%) underwent catheter ablation. The procedure was successful in 58 pts (82%). During follow-up, 30 (52%) of the 58 successfully treated patients had recurrences of RVOT-T. The mean time to recurrence was 6.28 years (95% CI 4.96-7.6). RVOT-T recurrences were similar in morphology to those treated previously in 33% and different in 67% of cases.CONCLUSIONS: Long-term follow-up in patients with RVOT-T is favourable. Catheter ablation is effective in this setting. However, late recurrences with similar or different morphology may arise in half of the patients after initially successful treatment. AA drug therapy is a valid initial therapeutic option, since it is effective in about half of the patients.

KW - Adult

KW - Anti-Arrhythmia Agents/therapeutic use

KW - Cardiac Electrophysiology

KW - Catheter Ablation

KW - Coronary Angiography

KW - Echocardiography

KW - Exercise Test

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Recurrence

KW - Retrospective Studies

KW - Tachycardia, Ventricular/mortality

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1093/eurheartj/ehm293

DO - 10.1093/eurheartj/ehm293

M3 - SCORING: Journal article

C2 - 17656346

VL - 28

SP - 2338

EP - 2345

JO - EUR HEART J

JF - EUR HEART J

SN - 0195-668X

IS - 19

ER -