title: Incidence and prognosis of ventricular arrhythmias in patients with congenital left ventricular aneurysms or diverticula.
abstract: BACKGROUND
  Patients with congenital left ventricular aneurysms and diverticula may present with arrhythmia. The incidence of ventricular arrhythmias and the clinical outcome of these patients have not been reported to date.
  
  
  METHODS
  Among 250 consecutive patients with congenital left ventricular aneurysms and diverticula detected by echocardiography, the clinical outcome of patients who presented with ventricular arrhythmias or associated symptoms was investigated.
  
  
  RESULTS
  Of 250 patients with congenital left ventricular aneurysms and diverticula, 30 had ventricular arrhythmias or syncope at initial presentation. During a follow-up of 85 months, spontaneous ventricular tachycardia occurred in 17 of these patients (57%). Ventricular tachycardia was sustained in 13, with a monomorphic pattern in 9 patients. In 82% (11 patients), ventricular tachycardia was inducible during electrophysiologic testing. In 7 patients a sustained monomorphic ventricular tachycardia with a right bundle branch block pattern similar to the clinical tachycardia was induced. Twenty patients were treated with antiarrhythmic agents. Eleven patients received an implantable cardioverter defibrillator. Appropriate device discharges were observed in 73% during a follow-up of 61 months. One patient underwent surgical resection of a congenital left ventricular aneurysm. Three patients underwent successful catheter ablation for incessant ventricular tachycardia. Of these, 2 were free of any clinically relevant arrhythmia during follow-up. Three patients died (10, 41, and 89 months after initial presentation). In 2 of them, the cause of death was attributed to ventricular arrhythmia.
  
  
  CONCLUSIONS
  The clinical outcome of patients with congenital left ventricular aneurysms and diverticula and arrhythmia is variable. Clinical ventricular tachycardia in these patients is often monomorphic and usually inducible during electrophysiologic study, indicating a role for this test in risk stratification. Appropriate discharges are frequent in implantable cardioverter defibrillator recipients with congenital left ventricular aneurysms and diverticula.
authors.affiliation: Clinic for Cardiology, University Heart Center, University Hospital Zürich, Zürich, Switzerland. Electronic address: laurent.haegeli@usz.ch.
authors.forename: Laurent M
authors.initials: LM
authors.lastname: Haegeli
authors.affiliation: Clinic for Cardiology, University Heart Center, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Ercüment
authors.initials: E
authors.lastname: Ercin
authors.affiliation: Clinic for Cardiology, University Heart Center, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Jan
authors.initials: J
authors.lastname: Steffel
authors.affiliation: Clinic for Cardiology, University Heart Center, University Hospital Zürich, Zürich, Switzerland; Center for Integrative Human Physiology, University of Zürich, Zürich, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wolber
authors.affiliation: Clinic for Cardiology, University Heart Center, University Hospital Zürich, Zürich, Switzerland; Center for Integrative Human Physiology, University of Zürich, Zürich, Switzerland.
authors.forename: Felix C
authors.initials: FC
authors.lastname: Tanner
authors.affiliation: Clinic for Cardiology, University Heart Center, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Rolf
authors.initials: R
authors.lastname: Jenni
authors.affiliation: Clinic for Cardiology, University Heart Center, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Oliver
authors.initials: O
authors.lastname: Gämperli
authors.affiliation: Clinic for Cardiology, University Heart Center, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Ardan M
authors.initials: AM
authors.lastname: Saguner
authors.affiliation: Clinic for Cardiology, University Heart Center, University Hospital Zürich, Zürich, Switzerland; Center for Integrative Human Physiology, University of Zürich, Zürich, Switzerland.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.affiliation: Clinic for Cardiology, University Heart Center, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Corinna
authors.initials: C
authors.lastname: Brunckhorst
authors.affiliation: Clinic for Cardiology, University Heart Center, University Hospital Zürich, Zürich, Switzerland; Center for Integrative Human Physiology, University of Zürich, Zürich, Switzerland.
authors.forename: Firat
authors.initials: F
authors.lastname: Duru
mesh_terms: D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D005260:Female; D006322:Heart Aneurysm / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000188:drug therapy / Q000209:etiology*; D055815:Young Adult
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Aneurysm; Diverticula; Electrophysiology; Idiopathic; Ventricular tachycardia