Abstract
Purpose
Evaluation of the impact of catheter ablation for ventricular extrasystoles (VES) in structurally normal hearts on quality of life (QOL) and symptomatology.
Methods
Symptom analysis assessed with a disease-specific questionnaire, EHRA score for AF, and QOL analysis at baseline and 1 year after ablation.
Results
The study enrolled 39 patients between April 2016 and November 2019. Two patients were excluded from further analysis. At baseline, palpitations were reported in 31/37 (84%); syncope in 12/37 (32%); other cardiac symptoms in 33/37 (89%) of patients. The EHRA score was 3 or 4 in 13 patients (35%). With the modified arrhythmia-specific questionnaire (MASQ) psychological and physical scores were 46 and 39%. The overall perception of health in the SF-36 was 56 ± 16%. Ablation was performed in 35/37 (95%). At regular follow-up, symptoms were reported in 14/37 (38%) patients. ECG suggested a good procedural outcome in 65% with VES burden on Holter < 1% in 68%. At follow-up, palpitations were reported in 61% (P < 0.07); syncope in only 1 patient (P < 0.05). The EHRA score was 3 or 4 in only one patient (P < 0.05). MASQ scores improved to 62 and 60% (both p < 0.001). The overall perception of health in the SF-36 became 64 ± 17% (P < 0.02).
Conclusions
Patients with VES suffer from a wide variety of symptoms and have a low quality of life, as demonstrated by the EHRA score and conventional questionnaires. After catheter ablation, palpitations are still reported, but become less frequently present. Syncope becomes rare. Quality of life improves significantly from all perspectives.
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Data availability
After patients signed the informed consent, all data were anonymized for further evaluation.
Code availability
Not applicable.
References
Lerman BB. Mechanism, diagnosis, and treatment of outflow tract tachycardia. Nat Rev Cardiol. 2015;12:597–608.
Moorman FM, Christoffels VM. Cardiac chamber formation: development, genes, and evolution. Physiol Rev. 2003;83:1223–67.
Prystowsky EN, Padanilam BJ, Joshi S, Fogel RI. Ventricular arrhythmias in the absence of structural heart disease. J Am Coll Cardiol. 2012;59:1733–44.
Baman TS, Lange DC, Ilg KJ, Gupta SK, Liu T, Alguire C, Armstrong W, Good E, Jongnarangsin K, Pelosi F Jr, Crawford T, Ebinger M, Oral H, Morady F, Bogun F. Relationship between burden of premature ventricular complexes and left ventricular function. Heart Rhythm. 2010;7:865–9.
Penela D, Fernández-Armenta J, Aguinaga L, Tercedor L, Ordoñez A, Bisbal F, Acosta J, Rossi L, Borras R, Doltra A, Ortiz-Pérez JT, Bosch X, Perea RJ, Prat-González S, Soto-Iglesias D, Tolosana JM, Vassanelli F, Cabrera M, Linhart M, Martinez M, Mont L, Berruezo A. Clinical recognition of pure premature ventricular complex-induced cardiomyopathy at presentation. Heart Rhythm. 2017;14:1864–70.
Luebbert J, Auberson D, Marchlinski F. Premature ventricular complexes in apparently normal hearts. Card Electrophysiol Clin. 2016;8:503–14.
Tung R, Bauer B, Schelbert H, Lynch J, Auerbach M, Gupta P, et al. Incidence of abnormal positron emission tomography in patients with unexplained cardiomyopathy and ventricular arrhythmias. Heart Rhythm. 2015;12:2488–98.
Noda T, Shimizu W, Taguchi A, Aiba T, Satomi K, Suyama K, Kurita T, et al. Malignant entity of idiopathic ventricular fibrillation and polymorphic ventricular tachycardia initiated by premature extrasystoles originating from the right ventricular outflow tract. J Am Coll Cardiol. 2005;46:1288–94.
Valk SD, Dabiri-Abkenari L, Theuns DA, Thornton AS, Res JC, Jordaens L. Ventricular fibrillation and life-threatening ventricular tachycardia in the setting of outflow tract arrhythmias - The place of ICD therapy. Int J Cardiol. 2013;165:385–7.
Fichtner S, Senges J, Hochadel M, Tilz R, Willems S, Eckardt L, Deneke T, Lewalter T, Dorwarth U, Reithmann C, Brachmann J, Steinbeck G, Kääb S; German Ablation Registry. Safety and efficacy in ablation of premature ventricular contraction: data from the German ablation registry. Clin Res Cardiol. 2017;106:49–57.
Voskoboinik A, Hadjis A, Alhede C, Im SI, Park H, Moss J, Marcus GM, Hsia H, Lee B, Tseng Z, Lee R, Scheinman M, Vedantham V, Vittinghoff E, Park KM, Gerstenfeld EP. Predictors of adverse outcome in patients with frequent premature ventricular complexes: the ABC-VT risk score. Heart Rhythm. 2020;17:1066–74.
Ventura R, Steven D, Klemm HU, Lutomsky B, Mullerleile K, Rostock T, servatius H, Meinertz T, Kuck KH, Willems S. Decennial follow-up in patients with recurrent tachycardia originating fron the right ventricular outflow tract: electrophysiologic characteristics and response to treatment. Eur Heart J. 2007;28(19):2338–2345.
Valk SD, de Groot NM, Szili-Torok T, Van Belle YL, Res JC, Jordaens L. Clinical characteristics and acute results of catheter ablation for outflow tract ventricular tachycardia or premature beats. J Interv Card Electrophysiol. 2012;35:301–9.
Singh SN, Fletcher RD, Fisher SG, Singh BN, Lewis HD, Deedwania PC, Massie BM, Colling C, Lazzeri D. Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure. N Engl J Med. 1995;333:77–82.
Thornton AS, Jordaens LJ. Remote magnetic navigation for mapping and ablating right ventricular outflow tract tachycardia. Heart Rhythm. 2006;3:691–6.
Ling Z, Liu Z, Su L, Zipunnikov V, Wu J, Du H, Woo K, Chen S, Zhong B, Lan X, Fan J, Xu Y, Chen W, Yin Y, Nazarian S, Zrenner B. Radiofrequency ablation versus antiarrhythmic medication for treatment of ventricular premature beats from the right ventricular outflow tract: prospective randomized study. Circ Arrhythm Electrophysiol. 2014;7:237–43.
Yokokawa M, Good E, Crawford T, Chugh A, Pelosi F Jr, Latchamsetty R, Jongnarangsin K, Armstrong W, Ghanbari H, Oral H, Morady F, Bogun F. Recovery from left ventricular dysfunction after ablation of frequent premature ventricular complexes. Heart Rhythm. 2013;10:172–5.
Lamba J, Redfearn DP, Michael KA, Simpson CS, Abdollah H, Baranchuk A. Radiofrequency catheter ablation for the treatment of idiopathic premature ventricular contractions originating from the right ventricular outflow tract: a systematic review and meta-analysis. Pacing Clin Electrophysiol. 2014;37:73–8.
Sadron Blaye-Felice M, Hamon D, Sacher F, Pascale P, Rollin A, Bongard V, Duparc A, Mondoly P, Derval N, Denis A, Cardin C, Hocini M, Jaïs P, Pruvot E, Schlaepfer J, Carrié D, Galinier M, Lellouche N, Haïssaguerre M, Maury P. Reversal of left ventricular dysfunction after ablation of premature ventricular contractions related parameters, paradoxes and exceptions to the rule. Int J Cardiol. 2016;222:31–6.
VanderZee KI, Sanderman R, Heyink JW, de Haes H. Psychometric qualities of the RAND 36-Item Health Survey 1.0: a multidimensional measure of general health status. Int J Behav Med. 1996;3:104–22.
Arribas F, Ormaetxe JM, Peinado R, Perulero N, Ramirez P, Badia X. Validation of the AF-QoL, a disease-specific quality of life questionnaire for patients with atrial fibrillation. Europace. 2010;12:364–70.
Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;7:2893–962.
Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, Elliott PM, et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J. 2015;36:2793–2867.
Lelakowski J, Kuniewicc M, Rydlewska A, Kafara M. Quality of life after RF ablation of reentrant supraventricular tachycardias and ventricular ectopic beats in own observation. Pol Merkur Lekarski. 2010;168:438–430.
Huang CX, Liang JJ, Yang B, Jiang H, Tang QZ, Liu XJ, Wan WG, Jian XL. Quality of life and cost for patients with premature ventricular contractions by radiofrequency catheter ablation. Pacing Clin Electrophysiol. 2006;29:343–50.
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Approval by the Ethics Committee of the Ghent University Hospital was granted for this prospective data analysis (ref. B670201628001) and all patients signed an informed consent at inclusion.
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Timmers, L., Vervaet, P., Goethals, P. et al. Quality of life and symptoms in patients selected for ablation of ventricular extrasystoles: a prospective study. J Interv Card Electrophysiol 65, 601–607 (2022). https://doi.org/10.1007/s10840-021-01092-x
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DOI: https://doi.org/10.1007/s10840-021-01092-x