Abstract 13646: Clinical Profile and Ablation Outcomes in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy and Biventricular Involvement

Abstract

Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a progressive disease which can involve both ventricles. This study aimed to elucidate the clinical profile and ablation efficacy in Chinese ARVC patients with biventricular (BiV) involvement. Methods and Results: Based on cardiovascular magnetic resonance findings, 255 ARVC patients were divided into two groups: the BiV involved group (n=137) and the isolated right ventricular (RV) involved group (n=118). Patients with BiV involvement were more likely to suffer from heart failure (28.5% vs. 8.5%; P <0.001) and recurrent syncope (32.8% vs. 21.2%; P =0.038), and presented with lower heart transplantation-free survival and composed endpoint (death or heart transplantation)-free survival (all P <0.05). Of the 255 subjects, 52 BiV involved patients and 77 isolated RV involved patients underwent catheter ablation for ventricular tachycardia (VT). After 5 years’ follow-up, the outcomes including VT recurrence and all-cause mortality in 2 groups showed no difference (all P >0.05). The age, amount of induced VT during electrophysiology study and non-acute procedural success (partial success, defined as inducing the same VT with cycle length 30% longer after ablation; substrate modification only) were independent predictors of VT recurrence in BiV involved patients (all P <0.05). Conclusion: BiV involvement in ARVC indicated worse symptoms and poor prognosis. Nonetheless, catheter ablation remained effective for VT control in this population. The younger age, more induced VTs and non-acute procedural success were associated with VT recurrence after ablation.