title: Catheter ablation reduces ventricular tachycardia burden in patients with arrhythmogenic right ventricular cardiomyopathy: insights from a north-western French multicentre registry.
abstract: Studies assessing radiofrequency ablation (RFA) of ventricular tachycardia (VT) in arrhythmogenic right ventricular cardiomyopathy (ARVC) report VT recurrences, but have not evaluated the impact of RFA on relevant clinical events during follow-up. We aimed to investigate relevant RFA outcomes in a multicentric registry.
  
  
  
  This study included 49 patients with ARVC (46 with definite diagnosis, 3 with borderline diagnosis according to revised Task Force Criteria) who underwent 92 RFA procedures (83 endocardial, 9 combined endo-epicardial) between 1999-2015. Ventricular tachycardia recurrences and VT burden were assessed after each procedure or after the last RFA. Over a mean follow-up of 64 ± 51 months, VT-free survival was 37% at 1 year, 19% at 5 years, and 14% at 10 years. Ventricular tachycardia burden was significantly reduced after one procedure (23 vs. 11 VT episodes/year, P < 0.01) and after the last RFA (14 vs. 2 VT episodes/year, P < 0.01). Over a mean follow-up of 49 ± 52 months, clinical response after the last RFA (freedom from sudden cardiac death, VT requiring hospitalization, or heart transplantation) was 86% at 1 year, 69% at 5 years, and 60% at 10 years. Clinical response was associated with right ventricular dysfunction (RVD) and low numbers of mappable VT before the first RFA.
  
  
  
  RFA was predominantly targeted at the endocardial surface. Ventricular tachycardia recurrences were common, but few ARVC patients experienced major clinical events during follow-up. Further studies should investigate the benefit of extensive substrate ablation combined with endo-epicardial strategies.
authors.affiliation: Department of Cardiovascular Medicine, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire de Lille, University Lille CHU Lille, Boulevard du Professeur Leclercq, F-59000 Lille Cedex, France.
authors.forename: Zouheir
authors.initials: Z
authors.lastname: Souissi
authors.affiliation: Department of Cardiovascular Medicine, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire de Lille, University Lille CHU Lille, Boulevard du Professeur Leclercq, F-59000 Lille Cedex, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Boulé
authors.affiliation: Department of Cardiovascular Medicine, Amiens University Hospital, Amiens, France.
authors.forename: Jean-Sylvain
authors.initials: JS
authors.lastname: Hermida
authors.affiliation: Department of Cardiovascular Medicine, Amiens University Hospital, Amiens, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Doucy
authors.affiliation: Department of Cardiovascular Medicine, Rennes University Hospital, Rennes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Mabo
authors.affiliation: Department of Cardiovascular Medicine, Rennes University Hospital, Rennes, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Pavin
authors.affiliation: Department of Cardiovascular Medicine, Rouen University Hospital, Rouen, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Anselme
authors.affiliation: Department of Cardiovascular Medicine, Rouen University Hospital, Rouen, France.
authors.forename: Nathanaël
authors.initials: N
authors.lastname: Auquier
authors.affiliation: Department of Cardiovascular Medicine, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire de Lille, University Lille CHU Lille, Boulevard du Professeur Leclercq, F-59000 Lille Cedex, France.|Service d'Explorations Fonctionnelles Cardio-Vasculaires, University Hospital of Lille, France.|European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, F-59000, Lille, France.|University Lille, F-59000, Lille, France.|Inserm UMR 1011, F-59000, Lille, France.|Institut Pasteur de Lille, F-59000 Lille, France.
authors.forename: Sandro
authors.initials: S
authors.lastname: Ninni
authors.affiliation: Department of Cardiovascular Medicine, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire de Lille, University Lille CHU Lille, Boulevard du Professeur Leclercq, F-59000 Lille Cedex, France.|Service d'Explorations Fonctionnelles Cardio-Vasculaires, University Hospital of Lille, France.|European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, F-59000, Lille, France.|University Lille, F-59000, Lille, France.|Inserm UMR 1011, F-59000, Lille, France.|Institut Pasteur de Lille, F-59000 Lille, France.
authors.forename: Augustin
authors.initials: A
authors.lastname: Coisne
authors.affiliation: Department of Cardiovascular Medicine, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire de Lille, University Lille CHU Lille, Boulevard du Professeur Leclercq, F-59000 Lille Cedex, France.
authors.forename: François
authors.initials: F
authors.lastname: Brigadeau
authors.affiliation: University Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000 Lille, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Deken-Delannoy
authors.affiliation: Department of Cardiovascular Medicine, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire de Lille, University Lille CHU Lille, Boulevard du Professeur Leclercq, F-59000 Lille Cedex, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Klug
authors.affiliation: Department of Cardiovascular Medicine, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire de Lille, University Lille CHU Lille, Boulevard du Professeur Leclercq, F-59000 Lille Cedex, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Lacroix
mesh_terms: D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017115:Catheter Ablation / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Arrhythmogenic right ventricular cardiomyopathy; Catheter ablation; Ventricular tachycardia