title: The application of signal average ECG in the prediction of recurrences after catheter ablation of ventricular arrhythmias in arrhythmogenic right ventricular dysplasia/cardiomyopathy.
abstract: BACKGROUND
  The changes of signal averaged ECG (SAECG) in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) undergoing radiofrequency catheter ablation (RFCA) of ventricular arrhythmias (VAs) remains unknown.
  
  
  METHODS
  Between 2010 and 2014, a total of 81 ARVD/C patients underwent endocardial and/or epicardial RFCA for drug-refractory VAs. Seventy patients (mean age 46.2±14.1years, 37 males) achieving acute procedure success (negative inducibility) were enrolled. Baseline characteristics, non-invasive examinations and SAECG (before and 3months after RFCA) were collected retrospectively.
  
  
  RESULTS
  After successful RFCA, the electrical parameters of SAECG changed in 39 patients (55.7%), including 28 patients (40%) with electrical regression (group 1), and 11 patients (15.7%) with electrical progression (group 3). Thirty-one patients (44.3%) showed no significant SAECG change (group 2). During a mean follow-up of 17.8±10.7months, 23 patients (32.9%) had VA recurrences, including 4 in group 1, 12 in group 2, and 7 in group 3. In comparisons with groups 2 and 3, group 1 patients had a significantly better VA recurrence-free survival (P=0.02). In multivariable Cox regression analysis, electrical regression was found to be associated with fewer VA recurrences (P=0.02, OR: 0.28, 95% CI: 0.10-0.83).
  
  
  CONCLUSIONS
  Electrical regression of SAECG after RFCA in ARVD/C was found to be associated with fewer VA recurrences.
authors.affiliation: Division of Electrophysiology, Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan.
authors.forename: Ying-Chieh
authors.initials: YC
authors.lastname: Liao
authors.affiliation: Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.
authors.forename: Fa-Po
authors.initials: FP
authors.lastname: Chung
authors.affiliation: Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.
authors.forename: Yenn-Jiang
authors.initials: YJ
authors.lastname: Lin
authors.affiliation: Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.
authors.forename: Shih-Lin
authors.initials: SL
authors.lastname: Chang
authors.affiliation: Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Lo
authors.affiliation: Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Hu
authors.affiliation: Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.
authors.forename: Ta-Chuan
authors.initials: TC
authors.lastname: Tuan
authors.affiliation: Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.
authors.forename: Tze-Fan
authors.initials: TF
authors.lastname: Chao
authors.affiliation: Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.
authors.forename: Jo-Nan
authors.initials: JN
authors.lastname: Liao
authors.affiliation: Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.
authors.forename: Chin-Yu
authors.initials: CY
authors.lastname: Lin
authors.affiliation: Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.
authors.forename: Yao-Ting
authors.initials: YT
authors.lastname: Chang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Taipei Wan-Fang Hospital, Taipei Medical University, Taiwan; Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taiwan. Electronic address: mhhsieh@tmu.edu.tw.
authors.forename: Ming-Hsiung
authors.initials: MH
authors.lastname: Hsieh
authors.affiliation: Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000639:trends*; D015331:Cohort Studies; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*
keywords: ARVD/C; Catheter ablation; Electrical regression; SAECG; Ventricular arrhythmia