title: Recovery of renal dysfunction after catheter ablation of outflow tract ventricular arrhythmias in patients with ventricular premature depolarization-mediated cardiomyopathy.
abstract: OBJECTIVE
  Frequent ventricular premature depolarizations (VPDs) may cause cardiomyopathy (VPDCM), which often improves after VPD suppression. This study aimed to evaluate whether ablation of outflow tract ventricular arrhythmias (OT VAs) in patients with VPDCM improves renal in addition to left ventricular (LV) function.
  
  
  METHODS
  We retrospectively evaluated 153 patients with OT VAs and examined VPD burden and LV ejection fraction (LVEF), as well as estimated glomerular filtration rate (eGFR) pre- and post-ablation. LV dysfunction was defined as LVEF <50 % and impaired renal function was defined as eGFR of <60 mL/min/1.73m2.
  
  
  RESULTS
  Fifty-five patients had VPDCM. During mean follow-up of 14 months, 140 (92 %) were free from arrhythmia. In patients with VPDCM, patients with baseline LVEF 40-50 % had greater improvement in the post-ablation LVEF compared to patients with baseline LVEF <40 % (p < 0.01). At baseline, 36 (72 %) patients had renal dysfunction, 29 (81 %) of whom had improvement in eGFR from baseline after successful ablation from eGFR 51 to 57 mL/min/1.73m2. There was a significant association between cardiac (ΔLVEF ≥10 %) and renal (ΔeGFR ≥10 %) improvement (r = 0.54, p = 0.04). Using logistic regression analysis, procedural success was an independent predictor of improvement of cardiac (odds ratio [OR] = 13.7, p = 0.03) and renal function (OR = 21.0, p = 0.047).
  
  
  CONCLUSIONS
  Successful catheter ablation of OT VA reduces VPD burden and is associated with improved cardiac and renal function in patients with VPDCM.
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA.
authors.forename: Shingo
authors.initials: S
authors.lastname: Maeda
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA.
authors.forename: William W
authors.initials: WW
authors.lastname: Chik
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA.
authors.forename: Jackson J
authors.initials: JJ
authors.lastname: Liang
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA.
authors.forename: Iosif
authors.initials: I
authors.lastname: Kelesidis
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA.
authors.forename: Ruben Casado
authors.initials: RC
authors.lastname: Arroyo
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: D'Souza
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA.
authors.forename: Mouhannad M
authors.initials: MM
authors.lastname: Sadek
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA.
authors.forename: Daniele
authors.initials: D
authors.lastname: Muser
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA.
authors.forename: Fabien
authors.initials: F
authors.lastname: Squara
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA.
authors.forename: Deviprasad
authors.initials: D
authors.lastname: Venugopal
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Santangeli
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Frankel
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA.
authors.forename: Erica S
authors.initials: ES
authors.lastname: Zado
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA.
authors.forename: Francis E
authors.initials: FE
authors.lastname: Marchlinski
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA, 19104, USA. David.Callans@uphs.upenn.edu.
authors.forename: David J
authors.initials: DJ
authors.lastname: Callans
mesh_terms: D017115:Catheter Ablation / Q000706:statistics & numerical data*; D015984:Causality; D015897:Comorbidity; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D015995:Prevalence; D020127:Recovery of Function; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D016896:Treatment Outcome; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*
keywords: Catheter ablation; Chronic kidney disease; Outflow tract ventricular arrhythmias; Ventricular premature depolarization