title: Metabolic syndrome is associated with a poor outcome in patients affected by outflow tract premature ventricular contractions treated by catheter ablation.
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.
authors.forename: Celestino
authors.initials: C
authors.lastname: Sardu
authors.forename: Giovanni
authors.initials: G
authors.lastname: Carreras
authors.forename: Spyridon
authors.initials: S
authors.lastname: Katsanos
authors.forename: Vasileios
authors.initials: V
authors.lastname: Kamperidis
authors.forename: Maria Caterina
authors.initials: MC
authors.lastname: Pace
authors.forename: Maria Beatrice
authors.initials: MB
authors.lastname: Passavanti
authors.forename: Ilaria
authors.initials: I
authors.lastname: Fava
authors.forename: Pasquale
authors.initials: P
authors.lastname: Paolisso
authors.forename: Gorizio
authors.initials: G
authors.lastname: Pieretti
authors.forename: Giovanni Francesco
authors.initials: GF
authors.lastname: Nicoletti
authors.forename: Gaetano
authors.initials: G
authors.lastname: Santulli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Paolisso
authors.affiliation: Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Second University of Naples, Naples, Italy. raffaele.marfella@unina2.it.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Marfella
mesh_terms: D017115:Catheter Ablation; D006801:Humans; D024821:Metabolic Syndrome / Q000150:complications*; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D018879:Ventricular Premature Complexes / Q000150:complications* / Q000601:surgery*