What is the clinical evidence from this study?

Study design: Cohort. Population: outflow tract premature ventricular contractions (n=90). Intervention: Metabolic syndrome vs. Without metabolic syndrome. Primary outcome: composite of recurrence of acute or delayed outflow tract ventricular arrhythmia (HR 9.655, 95% CI 3.000-31.068, p=<0.001).

December 1, 2014Open Access

Metabolic syndrome is associated with a poor outcome in patients affected by outflow tract premature ventricular contractions treated by catheter ablation

Q: What are the key findings of this study?

Metabolic syndrome was independently associated with a significantly higher risk of acute or delayed recurrence of outflow tract premature ventricular contractions after catheter ablation (HR 9.655).

Key Result

Metabolic syndrome was independently associated with a significantly higher risk of acute or delayed recurrence of outflow tract premature ventricular contractions after catheter ablation (HR 9.655).

Study Design

Type

Cohort (n=90)

Multicenter

Yes

Structured PICO

Does metabolic syndrome increase the recurrence of outflow tract PVCs after catheter ablation in patients without structural heart disease?

Population

90 patients with frequent premature ventricular contraction beats (PVCs) originating from right ventricular outflow tract (RVOT, n=68), left ventricular outflow tract (LVOT, n=19) or coronary cusps (CUSPs, n=3), with normal ventricular systolic function and absence of cardiac structural disease.

Intervention

Presence of metabolic syndrome (n=24)

Comparator

Absence of metabolic syndrome (n=66)

Outcome

Composite of recurrence of acute or delayed outflow tract ventricular arrhythmia: acute spontaneous or inducible outflow tract ventricular arrhythmia recurrence or recurrence of outflow tract PVCs in holter monitoring at follow upcomposite

Metabolic syndrome is strongly associated with a higher recurrence rate of outflow tract PVCs after catheter ablation in patients without structural heart disease.

Main Result

Effect estimate: HR 9.655 (95% CI 3.000-31.068)

p-value: p=<0.001

Limitations

Episodes of asymptomatic PVCs or more serious arrhythmias might have been missed during follow-up
Study sample size and follow-up duration may have been insufficient to fully characterize the incidence of lethal arrhythmias
Patients were not followed for any status change in their metabolic syndrome component
Waist circumference measurement data was not obtained
Number of subjects and ages in the study and control groups were not similar

Abstract

BACKGROUND: The purpose of this study was to investigate the impact of metabolic syndrome (MS) on outcome of catheter ablation (CA) for treatment of frequent premature ventricular contraction beats (PVCs) originating from right ventricular outflow tract (RVOT), left ventricular outflow tract (LVOT) or coronary cusps (CUSPs), in patients with normal ventricular systolic function and absence of cardiac structural disease. METHODS: In this multicentre prospective study we evaluated 90 patients with frequent PVCs originating from RVOT (n = 68), LVOT (n = 19) or CUSPs (n = 3), treated with CA. According to baseline diagnosis they were divided in patients with MS (n = 24) or without MS (n = 66). The study endpoint was a composite of recurrence of acute or delayed outflow tract ventricular arrhythmia: acute spontaneous or inducible outflow tract ventricular arrhythmia recurrence or recurrence of outflow tract PVCs in holter monitoring at follow up. RESULTS: Patients with MS compared to patients without MS showed a higher acute post-procedural recurrence of outflow tract PVCs (n = 8, 66.6%, vs. n = 6, 9.0%, p = 0.005). At a mean follow up of 35 (17-43) months survival free of recurrence of outflow tract PVCs was lower in patients with baseline MS compared to patients without MS diagnosis (log-rank test, p < 0.001). In cox regression analysis, only MS was independently associated with study endpoint (HR = 9.655 , 95% CI 3.000-31.0.68 , p < 0.001). CONCLUSIONS: MS is associated with a higher recurrence rate of outflow tract PVCs after CA in patients without structural heart disease.

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Cite This Study

Sardu et al. (Mon,) conducted a cohort in outflow tract premature ventricular contractions (n=90). Metabolic syndrome vs. Without metabolic syndrome was evaluated on composite of recurrence of acute or delayed outflow tract ventricular arrhythmia (HR 9.655, 95% CI 3.000-31.068, p=<0.001). Metabolic syndrome was independently associated with a significantly higher risk of acute or delayed recurrence of outflow tract premature ventricular contractions after catheter ablation (HR 9.655).

synapsesocial.com/papers/6a0f20f5a7a2fed64abdbc72 https://doi.org/https://doi.org/10.1186/1471-2261-14-176

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