Impact of Amiodarone Therapy on the Ablation Outcome of Ventricular Tachycardia in Arrhythmogenic Right Ventricular Cardiomyopathy

Chin Yu Lin, Fa Po Chung*, Nwe Nwe, Yu Cheng Hsieh, Cheng Hung Li, Yenn Jiang Lin, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Ta Chuan Tuan, Tze Fan Chao, Jo Nan Liao, Ting Yung Chang, Ling Kuo, Cheng I. Wu, Chih Min Liu, Shin Huei Liu, Wen Han Cheng, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

(1) Background: Catheter ablation (CA) is an accepted treatment option for drug-refractory ventricular tachycardia (VT) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). This study investigates the effect of amiodarone on ablation outcomes in ARVC. (2) Methods: The study enrolled patients with ARVC undergoing CA of sustained VT. In all patients, substrate modification was performed to achieve non-inducible VT. The patients were categorized into two groups according to whether they had used amiodarone before CA. Baseline and electrophysiological characteristics, substrate, and outcomes were compared. (3) Results: A total of 72 ARVC patients were studied, including 29 (40.3%) “off” amiodarone and 43 (56.7%) “on” amiodarone. The scar area was similar between the two groups. Patients “off” amiodarone had smaller endocardial and epicardial areas with abnormal electrograms. Twenty of 43 patients (47.5%) “on” amiodarone discontinued it within 3 months after CA. During a mean follow-up period of 43.2 ± 29.5 months, higher VT recurrence was observed in patients “on” amiodarone. Patients “on” amiodarone who discontinued amiodarone after CA had a lower recurrence than those without. (4) Conclusions: Patients with ARVC “on” amiodarone before CA had distinct substrate characteristics and worse ablation outcomes than patients “off” amiodarone, especially in those who had used amiodarone continuously.

Original languageEnglish
Article number7265
JournalJournal of Clinical Medicine
Volume11
Issue number24
DOIs
StatePublished - Dec 2022

Keywords

  • ablation
  • abnormal electrograms
  • amiodarone
  • arrhythmogenic right ventricular cardiomyopathy
  • ventricular tachycardia

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