title: Intracoronary infusion of mononuclear cells after PCI-treated myocardial infarction and arrhythmogenesis: is it safe?
abstract: To reduce long-term morbidity after revascularised acute myocardial infarction, different therapeutic strategies have been investigated. Cell therapy with mononuclear cells from bone marrow (BMMC) or peripheral blood (PBMC) has been proposed to attenuate the adverse processes of remodelling and subsequent heart failure. Previous trials have suggested that cell therapy may facilitate arrhythmogenesis. In the present substudy of the HEBE cell therapy trial, we investigated whether intracoronary cell therapy alters the prevalence of ventricular arrhythmias after 1 month or the rate of severe arrhythmogenic events (SAE) in the first year. In 164 patients of the trial we measured function and infarct size with cardiovascular magnetic resonance (CMR) imaging. Holter registration was performed after 1 month from which the number of triplets (3 successive PVCs) and ventricular tachycardias (VT, ≥4 successive PVCs) was assessed. Thirty-three patients (20%) showed triplets and/or VTs, with similar distribution amongst the groups (triplets: control n = 8 vs. BMMC n = 9, p = 1.00; vs. PBMC n = 10, p = 0.67. VT: control n = 9 vs. BMMC n = 9, p = 0.80; vs. PBMC n = 11, p = 0.69). SAE occurred in 2 patients in the PBMC group and 1 patient in the control group. In conclusion, intracoronary cell therapy is not associated with an increase in ventricular arrhythmias or SAE.
authors.affiliation: Department of Cardiology, VU University Medical Center, ZH 5 F003, PO Box 7057, 1007 MB, Amsterdam, the Netherlands.
authors.forename: L F H J
authors.initials: LF
authors.lastname: Robbers
authors.forename: R
authors.initials: R
authors.lastname: Nijveldt
authors.forename: A M
authors.initials: AM
authors.lastname: Beek
authors.forename: M J B
authors.initials: MJ
authors.lastname: Kemme
authors.forename: R
authors.initials: R
authors.lastname: Delewi
authors.forename: A
authors.initials: A
authors.lastname: Hirsch
authors.forename: A M
authors.initials: AM
authors.lastname: van der Laan
authors.forename: P A
authors.initials: PA
authors.lastname: van der Vleuten
authors.forename: J J
authors.initials: JJ
authors.lastname: Piek
authors.forename: F
authors.initials: F
authors.lastname: Zijlstra
authors.forename: A C
authors.initials: AC
authors.lastname: van Rossum