title: Long-Term Outcomes of Radio-Frequency Catheter Ablation on Ventricular Tachycardias Due to Arrhythmogenic Right Ventricular Cardiomyopathy: A Single Center Experience.
abstract: OBJECTIVE
  To summarize our experience of radiofrequency catheter ablation (RFCA) for recurrent drug-refractory ventricular tachycardias (VTs) due to arrhythmogenic right ventricular cardiomyopathy (ARVC) in our center over the past 11 years and its related factors.
  
  
  RESULTS
  We reviewed 48 adults (mean age 39.9 ± 12.9 years, range: 14 to 65) who met the present ARVC diagnostic criteria and accepted RFCA for VTs from December 2004 to April 2016. The patients received a total of 70 procedures using two ablation approaches, the endocardial approach in 52 RFCAs, and the combined epicardial and endocardial approach (the combined approach) in 18 RFCAs. Kaplan-Meier survival analysis showed that the combined approach achieved better acute procedural success (p = 0.003) and better long-term outcomes (p = 0.028) than the endocardial approach. Patients who obtained acute procedural success with non-inducibility had better long-term outcomes (p < 0.001). COX regression of multivariate analysis showed that procedural success was the only factor that benefited long-term outcome, irrespective of the endocardial or the combined approach (p = 0.001). The rate of sudden cardiac death (SCD) in patients without procedural success was significantly higher than that in patients with procedural success (p = 0.005). All patients without implantable cardioverter defibrillator (ICD) implantation who had successful final RFCA survived.
  
  
  CONCLUSIONS
  The combined approach resulted in better procedural success and long-term VT-free survival compared with the endocardial approach in ARVC patients with recurrent VTs. Acute procedural success with non-inducibility was strongly related to better long-term VT-free survival and reduced SCD, irrespective of whether this was achieved by the endocardial approach or the combined approach.
authors.affiliation: Guangdong Cardiovascular Institute, Guangzhou, P.R. China.|Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, P.R. China.|Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.affiliation: Guangdong Cardiovascular Institute, Guangzhou, P.R. China.|Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, P.R. China.|Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
authors.forename: Hongtao
authors.initials: H
authors.lastname: Liao
authors.affiliation: Guangdong Cardiovascular Institute, Guangzhou, P.R. China.|Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, P.R. China.|Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
authors.forename: Yumei
authors.initials: Y
authors.lastname: Xue
authors.affiliation: Guangdong Cardiovascular Institute, Guangzhou, P.R. China.|Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, P.R. China.|Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
authors.forename: Xianhong
authors.initials: X
authors.lastname: Fang
authors.affiliation: Guangdong Cardiovascular Institute, Guangzhou, P.R. China.|Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, P.R. China.|Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
authors.forename: Jun
authors.initials: J
authors.lastname: Huang
authors.affiliation: Guangdong Cardiovascular Institute, Guangzhou, P.R. China.|Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, P.R. China.|Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Guangdong Cardiovascular Institute, Guangzhou, P.R. China.|Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, P.R. China.|Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
authors.forename: Hai
authors.initials: H
authors.lastname: Deng
authors.affiliation: Guangdong Cardiovascular Institute, Guangzhou, P.R. China.|Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, P.R. China.|Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
authors.forename: Yuanhong
authors.initials: Y
authors.lastname: Liang
authors.affiliation: Guangdong Cardiovascular Institute, Guangzhou, P.R. China.|Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, P.R. China.|Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
authors.forename: Zili
authors.initials: Z
authors.lastname: Liao
authors.affiliation: Guangdong Cardiovascular Institute, Guangzhou, P.R. China.|Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, P.R. China.|Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
authors.forename: Fangzhou
authors.initials: F
authors.lastname: Liu
authors.affiliation: Guangdong Cardiovascular Institute, Guangzhou, P.R. China.|Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, P.R. China.|Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Lin
authors.affiliation: Guangdong Cardiovascular Institute, Guangzhou, P.R. China.|Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, P.R. China.|Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
authors.forename: Xianzhang
authors.initials: X
authors.lastname: Zhan
authors.affiliation: Guangdong Cardiovascular Institute, Guangzhou, P.R. China.|Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, P.R. China.|Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
authors.forename: Shulin
authors.initials: S
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D017115:Catheter Ablation / Q000379:methods / Q000706:statistics & numerical data; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology; D017147:Defibrillators, Implantable; D056149:Epicardial Mapping; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult