Insight of electrocardiographic and electrophysiological parameters on the left ventricular function in patients with ventricular arrhythmia from left ventricular summit

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

*此作品的通信作者

研究成果: Article同行評審

摘要

Introduction: Ventricular arrhythmia (VA) commonly originate from the left ventricular summit (LVS) and results in left ventricular (LV) dysfunction in some patients; however, factors related to LV cardiomyopathy have not been well elucidated. Therefore, this study aimed to investigate the risk factors for LV cardiomyopathy and the outcomes of patients with LVS VA. Methods: Between 2013 and 2018, a total of 139 patients (60.7% men; mean age 53.2 ± 13.9 years old) underwent catheter ablation for LVS VA in two centers. Detailed patient demographics, electrocardiograms, electrophysiological characteristics, and clinical outcomes were analyzed. LV cardiomyopathy was defined as left ventricular ejection fraction (LVEF) <50%. Results: Acute procedural success was achieved in 92.8% of patients. There were 40 patients (28.8%) with LV cardiomyopathy, and the mean LVEF improved from 37.5 ± 9.3% to 48.5 ± 10.2% after ablation (p <.001). After multivariate analysis, the independent factors of LV dysfunction were wider QRS duration (QRSd) of the VA (odds ratio [OR] 1.02; 95% confidence interval [CI]: 1.00–1.04; p =.046) and the absolute earliest activation time discrepancy (AEAD) between epicardium and endocardium (OR 1.05; 95% CI: 1.00–1.09; p =.048). After ablation, the LV function was completely recovered in 20 patients (50%). The factors for LV dysfunction without recovery included wider premature ventricular complex (PVC) QRSd (OR 1.09; 95% CI: 1.02–1.17; p =.012) and poorer LVEF (OR 0.85; 95% CI: 0.74–0.97; p =.020). Conclusion: In patients with VA from the LVS, PVC QRSd and AEAD are factors associated with deteriorating LV systolic function. Catheter ablation can reverse LV remodeling. Narrower QRSd and better LVEF are associated with better recovery of LV function after ablation.

原文English
頁(從 - 到)1230-1240
頁數11
期刊Journal of cardiovascular electrophysiology
34
發行號5
DOIs
出版狀態Published - 5月 2023

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