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Title: | Electrophysiologic and electroanatomic characterization of ventricular arrhythmias in non-compaction cardiomyopathy: A systematic review |
Authors: | Bhaskaran, Ashwin;Campbell, Timothy G.;Virk, Sohaib;Bennett, Richard G.;Kizana, Eddy;Kumar, Saurabh |
WSLHD Author: | Bhaskaran, Ashwin;Campbell, Timothy G.;Virk, Sohaib;Bennett, Richard G.;Kizana, Eddy;Kumar, Saurabh |
Issue Date: | 2021 |
Citation: | Journal of Cardiovascular Electrophysiology 32(5):1421-1429, 2021 |
Abstract: | BACKGROUND: Non-compaction cardiomyopathy (NCCM) is a form of structural heart disease prone to ventricular arrhythmias (VAs) and sudden cardiac death. Non-compacted myocardium may harbor VA substrate, though some reports suggest otherwise. OBJECTIVE: This study aimed to characterize the electrophysiologic (EP) features of VA in NCCM. METHODS: We performed a systematic review of case reports, case series, and observational studies. RESULTS: One hundred and thirty-five cases of NCCM from studies between 2000 and 2020 were included. Mean age was 34 +/- 20 years, mean left ventricular (LV) ejection fraction was 42 +/- 15% with two cases having late gadolinium enhancement on magnetic resonance imaging. The LV apex was the most common non-compacted segment (86%); 10% involved the right ventricle (RV). Antiarrhythmic failure was documented in 16 cases, of which 50% failed more than one agent. Only 23% of monomorphic VAs localized to regions of non-compaction on electrocardiogram. Most frequently, VAs localized to the RV outflow tract (n = 21), posterior fascicle (n = 19), and anterolateral LV apex (n = 9). All cases with apical exits arose from the non-compacted myocardium. On EPS, 83% of sustained VTs were due to re-entry, 17% due to focal mechanism. Catheter ablation was performed in 39 cases, with 7 requiring more than 1 procedure. Acute VA non-inducibility was achieved in 82% and VA-free survival was reported in 85% over a mean follow-up of 24 months. CONCLUSION: The majority of VAs in NCCM arise remotely from non-compacted myocardium, and non-re-entrant mechanism seen in ~1/5th of sustained VTs. Catheter ablation outcomes appear favorable. Further study is needed to understand the pathophysiology of VA in NCCM. |
URI: | https://wslhd.intersearch.com.au/wslhdjspui/handle/1/4246 |
DOI: | https://dx.doi.org/10.1111/jce.15026 |
Journal: | Journal of Cardiovascular Electrophysiology |
Type: | Journal Article |
Study or Trial: | Research Support, Non-U.S. Gov't Systematic Review |
Facility: | Westmead |
Keywords: | Arrhythmias, Cardiac Cardiomyopathies Catheter Ablation Contrast Media Gadolinium Tachycardia, Ventricular |
Appears in Collections: | Westmead Hospital 2019 - 2024 |
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