PMID- 24621931
OWN - NLM
STAT- MEDLINE
DCOM- 20141117
LR  - 20170901
IS  - 2213-1787 (Electronic)
IS  - 2213-1779 (Linking)
VI  - 1
IP  - 4
DP  - 2013 Aug
TI  - Right heart function prediction of outcome in heart failure patients after 
      catheter ablation for recurrent ventricular tachycardia.
PG  - 281-289
LID - S2213-1779(13)00183-2 [pii]
LID - 10.1016/j.jchf.2013.05.003 [doi]
AB  - OBJECTIVES: This study sought to determine the relevance of echocardiographic 
      assessment focusing on right ventricular (RV) function to estimate prognosis in 
      patients with heart failure (HF) and low left ventricular ejection fraction 
      (LVEF) after ablation of ventricular tachycardia (VT). BACKGROUND: Recurrent VT 
      is a marker of increased mortality in HF. Decision making remains challenging as 
      some patients have a poor outcome despite successful catheter ablation of VT due 
      to progressive biventricular HF. METHODS: Retrospective analysis was performed on 
      data from 320 consecutive patients with HF and LVEF </=40% who underwent ablation 
      for recurrent VT between 1999 and 2008. Baseline clinical and echocardiographic 
      data were analyzed in relation to survival. RESULTS: Among the 320 patients 
      included, the mean age was 63 years, and 86% were male. During follow-up (median: 
      36 months) 127 patients (40%) died. RV dysfunction (hazard ratio [HR]: 1.4) and 
      tricuspid regurgitation (TR) (HR: 1.7), together with age, New York Heart 
      Association (NYHA) class, and serum creatinine, were independent predictors of 
      death in a Cox regression model. Mortality was more than 2-fold higher in 
      patients with at least moderate RV dysfunction and TR (HR: 2.6; p < 0.001). In 
      patients with at least moderate RV dysfunction, TR, and estimated pulmonary 
      arterial pressure >/=45 mm Hg, mortality was 61% at 2 years, compared with 16% in 
      patients with good RV function without pulmonary hypertension (p < 0.0001). 
      CONCLUSIONS: Despite low LVEF, patients with recurrent VT who had good RV 
      function without elevated pulmonary pressures had a good prognosis after VT 
      ablation. RV dysfunction, TR, and elevated pulmonary pressures identified a 
      high-risk group of VT survivors in whom additional interventions may be necessary 
      to improve survival.
CI  - Copyright (c) 2013 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Ujeyl, Amaar
AU  - Ujeyl A
AD  - Cardiovascular Division and Department of Medicine, Brigham and Women's Hospital, 
      Harvard Medical School, Boston, Massachusetts.
FAU - Inada, Keiichi
AU  - Inada K
AD  - Cardiovascular Division and Department of Medicine, Brigham and Women's Hospital, 
      Harvard Medical School, Boston, Massachusetts.
FAU - Hillmann, Katja
AU  - Hillmann K
AD  - Department of Economics, University of Hamburg, Hamburg, Germany.
FAU - Wohlmuth, Peter
AU  - Wohlmuth P
AD  - ProResearch, Asklepios Klinik Hamburg, Germany.
FAU - Kato, Mahoto
AU  - Kato M
AD  - Cardiovascular Division and Department of Medicine, Brigham and Women's Hospital, 
      Harvard Medical School, Boston, Massachusetts.
FAU - Tedrow, Usha
AU  - Tedrow U
AD  - Cardiovascular Division and Department of Medicine, Brigham and Women's Hospital, 
      Harvard Medical School, Boston, Massachusetts.
FAU - Stevenson, Lynne W
AU  - Stevenson LW
AD  - Cardiovascular Division and Department of Medicine, Brigham and Women's Hospital, 
      Harvard Medical School, Boston, Massachusetts. Electronic address: 
      lstevenson@partners.com.
FAU - Stevenson, William G
AU  - Stevenson WG
AD  - Cardiovascular Division and Department of Medicine, Brigham and Women's Hospital, 
      Harvard Medical School, Boston, Massachusetts.
LA  - eng
PT  - Journal Article
DEP - 20130805
PL  - United States
TA  - JACC Heart Fail
JT  - JACC. Heart failure
JID - 101598241
SB  - IM
CIN - JACC Heart Fail. 2014 Apr;2(2):198-9. PMID: 24720929
MH  - *Catheter Ablation
MH  - Female
MH  - Heart Failure/complications/diagnostic imaging/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
MH  - Tachycardia, Ventricular/etiology/*surgery
MH  - Ultrasonography
MH  - *Ventricular Function, Right
OTO - NOTNLM
OT  - ablation
OT  - heart failure
OT  - right ventricular function
OT  - ventricular tachycardia
EDAT- 2014/03/14 06:00
MHDA- 2014/11/18 06:00
CRDT- 2014/03/14 06:00
PHST- 2013/01/07 00:00 [received]
PHST- 2013/04/23 00:00 [revised]
PHST- 2013/05/03 00:00 [accepted]
PHST- 2014/03/14 06:00 [entrez]
PHST- 2014/03/14 06:00 [pubmed]
PHST- 2014/11/18 06:00 [medline]
AID - S2213-1779(13)00183-2 [pii]
AID - 10.1016/j.jchf.2013.05.003 [doi]
PST - ppublish
SO  - JACC Heart Fail. 2013 Aug;1(4):281-289. doi: 10.1016/j.jchf.2013.05.003. Epub 
      2013 Aug 5.