Author + information
- Justin A. Edward, MD,
- Matthew M. Zipse, MD,
- Christine Tompkins, MD,
- Paul D. Varosy, MD,
- Amneet Sandhu, MD,
- Michael Rosenberg, MD,
- Ryan Aleong, MD,
- Wendy S. Tzou, MD,
- Ryan T. Borne, MD,
- William H. Sauer, MD and
- Duy T. Nguyen, MD∗ ()
- University of Colorado, Section of Cardiac Electrophysiology, Division of Cardiology, Aurora, Colorado
- ↵∗Address for correspondence:
Dr. Duy T. Nguyen, 300 Pasteur Dr, H2152, Stanford University, Stanford, California 94305-5233.
Objectives The goal of this study was to determine the impact of catheter ablation in the region of papillary muscles (PMs) and valvular cusps (VC) on mitral, tricuspid, or aortic valve function.
Background Ventricular arrhythmias arising from PMs and VCs often require extensive catheter ablation. Little is known regarding the risk of valve dysfunction after radiofrequency catheter ablation of such arrhythmias.
Methods A retrospective analysis was completed for 149 PM and VC VT/premature ventricular contraction (PVC) ablations from 2008 to 2018 at our institution. Patient and procedural details were collected for VT and PVC ablation cases involving PMs and VCs with available echocardiographic data pre-ablation and post-ablation (within 6 months). Degree of valvular regurgitation (VR) was graded from 0 (none) to 4 (severe), and significant valvular dysfunction was defined as a 2+ change in VR.
Results Of 149 radiofrequency catheter ablation cases, there were 84 (56%) aortic valve cusp ablations, 60 (40%) left ventricular PM ablations, and 5 (3%) right ventricular PM ablations. There were no statistically significant differences between pre-ablation and post-ablation VR severity (p = 0.33). No patients had a 2+ grade change in VR severity when pre-ablation and post-ablation echocardiograms were compared. There were no significant sequelae requiring intervention in the post-ablation period. On follow-up of 36 ± 9 months, for those with a change in VR, the severity had improved to baseline or remained stable.
Conclusions Despite often-times extensive ablation on and around valvular networks, risk of longstanding or permanent valvular dysfunction after VT/PVC ablation is rare.
Dr. Tzou has received consultant fees/honoraria from Boston Scientific, Abbott, and Biosense Webster; honoraria from Medtronic and Biotronik; and consultant fees from BioSig.Drs. Sauer and Nguyen have received significant research grants from Biosense Webster and CardioNXT; educational grants from Biosense Webster, Boston Scientific, and Medtronic; have a provisional patent on partially insulated focused catheter ablation; and have nonpublic equity interests/stock options in CardioNXT. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received January 30, 2019.
- Accepted July 8, 2019.
- 2019 American College of Cardiology Foundation
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