Percutaneous pulmonary valve implantation was associated with a 7.5% incidence of transient peri-procedural ventricular tachycardia, with lower BMI increasing susceptibility (P=0.04).
Cohort (n=79)
No
Does percutaneous pulmonary valve implantation induce ventricular tachycardia in patients with congenital heart disease?
Percutaneous pulmonary valve implantation is associated with a 7.5% incidence of transient, peri-procedural ventricular tachycardia, particularly in patients with lower BMI, which appears to resolve without long-term recurrence.
BACKGROUND: Percutaneous pulmonary valve implantation (PPVI) is utilized for dysfunctional right ventricular outflow tracts (RVOT) to relieve obstruction, regurgitation, and RV dysfunction. PPVI has not been reported to induce arrhythmias. This study is the first to report the incidence of ventricular tachycardia (VT) after PPVI. METHODS: This was a retrospective study of all patients who had PPVI at a single institution. All patients were admitted after PPVI for overnight telemetry monitoring. Patients with no prior history of VT and newly detected VT within 24 hours post-PPVI were considered to have VT related to PPVI. RESULTS: In total, 79 patients had PPVI (age 17 ± 9 years, 66% tetralogy of Fallot/pulmonary atresia). PPVI-related VT was detected in 6 patients (7.5%). These patients had a lower BMI (17.5 ± 2.0 vs. 23.1 ± 6.6, P = 0.04). There was no difference in age, native conduit or percutaneous valve size, or change in the minimum diameter of the RVOT from pre- to post-PPVI. In the 6 patients, VT was non-sustained and monomorphic at rates between 120 and 170. Five started on β-blockers. No patient required surgical explantation of the valve. Over a median follow-up of 2 years, 4 have weaned off medications and all are free of recurrence of VT with normal Holters. CONCLUSIONS: PPVI may be associated with transient VT in the acute peri-procedural period. Patients of smaller size may be more susceptible. All patients were managed conservatively and none of the patients had a recurrence, which is suggestive of a transient phenomenon.
Loar et al. (Mon,) conducted a cohort in Dysfunctional right ventricular outflow tracts in congenital heart disease (n=79). Percutaneous pulmonary valve implantation (PPVI) was evaluated on Newly detected ventricular tachycardia within 24 hours post-PPVI. Percutaneous pulmonary valve implantation was associated with a 7.5% incidence of transient peri-procedural ventricular tachycardia, with lower BMI increasing susceptibility (P=0.04).