Characteristics of diurnal ventricular premature complex variation in right ventricular outflow tract arrhythmias after catheter ablation

Shih Jie Jhuo, Li Wei Lo, Shih Lin Chang, Yenn Jiang Lin, Fa Po Chung, Yu Feng Hu, Tze Fan Chao, Ta Chuan Tuan, Jo Nan Liao, Chin Yu Lin, Yao Ting Chang, Chung Hsing Lin, Rohit Walia, Abigail Louise D. Te, Shinya Yamada, Sunu Budhi Raharjo, Wei Hua Tang, Kun Tai Lee, Wen Ter Lai, Shih Ann Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Diurnal variations in ventricular tachyarrhythmias (VAs) have been demonstrated in idiopathic arrhythmogenic heart disease. The electrophysiological characteristics of diurnal variations in idiopathic right ventricular outflow tract (RVOT) VA have not previously been elucidated. Sixty-two consecutive patients undergoing catheter ablation for idiopathic RVOT VA (mean age: 42.8 ± 12.3 years, 35 females) were enrolled. The diurnal variation type (group 1, n = 36) was defined as those patients who had most ventricular premature contractions (VPCs) during the night hours by preprocedure Holter recordings. Group 2 (n = 26) was defined as those patients who did not have significant VPC variations. The baseline characteristics and electrophysiological properties were collected and analyzed, and the rates of recurrence after catheter ablation were compared between the 2 groups. In this study, heart rate variability analysis demonstrated lower low frequency/high frequency ratios in group 1 than in group 2 (3.95 ± 3.08 vs 6.26 ± 5.33; P = 0.042). There were no significant differences in baseline characteristics, echocardiography and electrophysiological characteristics between the 2 groups. During a mean follow-up period of 13.5 ± 11.0 months, a total of 16 patients had VA recurrences, including 13 patients from group 1 and 3 patients from group 2 (36.1% vs 12.5%, P = 0.039). This study demonstrated the effect of the autonomic nervous system in idiopathic RVOT VAs and that the diurnal variation type leads to a higher recurrence rate after catheter ablation.

Original languageEnglish
Article numbere6516
JournalMedicine (United States)
Issue number15
StatePublished - 1 Apr 2017


  • catheter ablation
  • diurnal variation
  • heart rate variability
  • recurrences
  • right ventricular outflow tract


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