医学
心脏病学
内科学
射血分数
心动过速
室性心动过速
心脏磁共振成像
PR间隔
束支阻滞
右束支阻滞
心源性猝死
左束支阻滞
导管消融
QRS波群
心脏病
植入式心律转复除颤器
心力衰竭
烧蚀
心电图
磁共振成像
心率
放射科
血压
作者
Zhaomin Li,Xiafeng Peng,Chang Cui,Yike Zhang,Weizhu Ju,Fengxiang Zhang,Gang Yang,Kai Gu,Hailei Liu,Zidun Wang,Xiaohong Jiang,Mingfang Li,Hongwu Chen,Minglong Chen
出处
期刊:Heart Rhythm
[Elsevier]
日期:2023-03-02
卷期号:20 (6): 815-821
标识
DOI:10.1016/j.hrthm.2023.02.027
摘要
Background Ablation strategies to treat bundle branch reentrant ventricular tachycardia (BBRT) are well described. However, reports of long-term follow-up outcomes in BBRT patients without structural heart disease (SHD) are limited. Objective The purpose of this study was to investigate the long-term follow-up prognosis of BBRT patients without SHD. Methods Changes in electrocardiographic and echocardiographic parameters were used to evaluate progression during follow-up. Potential pathogenic candidate variants were screened using a specific gene panel. Results Eleven consecutive BBRT patients without obvious SHD based on echocardiographic and cardiovascular magnetic resonance imaging results were enrolled. Median age was 20 (11–48) years, and median follow-up time was 72 months. During follow-up, PR interval [206 (158–360) ms vs 188 (158–300) ms; P = .018] and QRS duration [187 (155–240) ms vs 164 (130–178) ms; P = .008] each increased significantly compared with postablation. Right- and left-sided chamber dilation and reduced left ventricular ejection fraction (LVEF) also were observed. Clinical deterioration or events occurred in 8 patients: 1 sudden death; 3 both complete heart block and reduced LVEF; 2 significantly reduced LVEF; and 2 prolonged PR interval. Genetic testing results showed that 6 of 10 patients (excluding the patient with sudden death) had ≥1 potential pathogenic candidate variants. Conclusion Further deterioration of His–Purkinje system conduction was observed in young BBRT patients without SHD after ablation. The His–Purkinje system may be the first target of genetic predisposition. Ablation strategies to treat bundle branch reentrant ventricular tachycardia (BBRT) are well described. However, reports of long-term follow-up outcomes in BBRT patients without structural heart disease (SHD) are limited. The purpose of this study was to investigate the long-term follow-up prognosis of BBRT patients without SHD. Changes in electrocardiographic and echocardiographic parameters were used to evaluate progression during follow-up. Potential pathogenic candidate variants were screened using a specific gene panel. Eleven consecutive BBRT patients without obvious SHD based on echocardiographic and cardiovascular magnetic resonance imaging results were enrolled. Median age was 20 (11–48) years, and median follow-up time was 72 months. During follow-up, PR interval [206 (158–360) ms vs 188 (158–300) ms; P = .018] and QRS duration [187 (155–240) ms vs 164 (130–178) ms; P = .008] each increased significantly compared with postablation. Right- and left-sided chamber dilation and reduced left ventricular ejection fraction (LVEF) also were observed. Clinical deterioration or events occurred in 8 patients: 1 sudden death; 3 both complete heart block and reduced LVEF; 2 significantly reduced LVEF; and 2 prolonged PR interval. Genetic testing results showed that 6 of 10 patients (excluding the patient with sudden death) had ≥1 potential pathogenic candidate variants. Further deterioration of His–Purkinje system conduction was observed in young BBRT patients without SHD after ablation. The His–Purkinje system may be the first target of genetic predisposition.
科研通智能强力驱动
Strongly Powered by AbleSci AI