Why the study?
Catheter ablation is an accepted treatment for drug-refractory VT in ARVC, but the effect of amiodarone on ablation outcomes was unknown.
Does amiodarone therapy before catheter ablation affect ventricular tachycardia recurrence in patients with arrhythmogenic right ventricular cardiomyopathy?
Does amiodarone therapy before catheter ablation affect ventricular tachycardia recurrence in patients with arrhythmogenic right ventricular cardiomyopathy?
In patients with ARVC undergoing catheter ablation for VT, prior amiodarone use is associated with distinct substrate characteristics and higher rates of VT recurrence.
Pre-ablation amiodarone was associated with higher VT recurrence in ARVC; hypothesis-generating and should not yet change practice.
(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.
No takes yet. Share an insight, caveat, or question.
Lin et al. (2022) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: