Incidence of outflow tract ventricular tachycardia long after surgical aortic valve replacement
Abstract Background The peri‐outflow tract region could be the origin of ventricular tachycardia (VT) after aortic valve replacement (AVR). However, the clinical characteristics of outflow tract ventricular tachycardias (OTVTs) after AVR are yet to be clarified. This study investigated the incidence...
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doaj-0ba38e8671a24e80a62c2a7ba44540ab2021-04-06T06:07:11ZengWileyJournal of Arrhythmia1880-42761883-21482021-04-0137241842510.1002/joa3.12502Incidence of outflow tract ventricular tachycardia long after surgical aortic valve replacementKentaro Goto0Yuichi Ono1Yuki Osaka2Hidetsugu Nomoto3Toru Miyazaki4Asami Suzuki5Ken Kurihara6Takeshi Someya7Yoshihide Takahashi8Kenichiro Otomo9Masahiko Goya10Tetsuo Sasano11Division of Cardiovascular Medicine Ome Municipal General Hospital Tokyo JapanDivision of Cardiovascular Medicine Ome Municipal General Hospital Tokyo JapanDivision of Cardiovascular Medicine Ome Municipal General Hospital Tokyo JapanDivision of Cardiovascular Medicine Ome Municipal General Hospital Tokyo JapanDivision of Cardiovascular Medicine Ome Municipal General Hospital Tokyo JapanDivision of Cardiovascular Medicine Ome Municipal General Hospital Tokyo JapanDivision of Cardiovascular Medicine Ome Municipal General Hospital Tokyo JapanDivision of Cardiovascular Surgery Ome Municipal General Hospital Tokyo JapanDepartment of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo JapanDivision of Cardiovascular Medicine Ome Municipal General Hospital Tokyo JapanDepartment of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo JapanDepartment of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo JapanAbstract Background The peri‐outflow tract region could be the origin of ventricular tachycardia (VT) after aortic valve replacement (AVR). However, the clinical characteristics of outflow tract ventricular tachycardias (OTVTs) after AVR are yet to be clarified. This study investigated the incidence, risk factors, and clinical characteristics of patients with OTVTs after AVR. Methods We retrospectively analyzed the clinical course of 120 patients who had undergone surgical AVR (SAVR) between April 1980 and October 2018. The patients had no ischemic or diagnosed cardiomyopathies other than primary aortic valve diseases. Results Six patients (5.0%) developed OTVTs after SAVR. The average onset was at 10.8 ± 5.7 years after SAVR. All cases of VT arose from the inferior axis and included left and right bundle branch block configuration. Two patients who underwent cardiac magnetic resonance imaging (MRI) had late gadolinium enhancement (LGE) in the midlayer of the left ventricle basal anteroseptal wall. Patients with periaortic VTs had significantly larger left ventricular (LV) diameter at systole, lower LV ejection fraction, higher positive rates of signal‐averaged electrocardiogram (SAECG), and nonsustained VTs on Holter monitoring. On ablation, local fragmented potentials with low voltage zones were observed in accordance with the LGE distribution. Multiple VTs originating from the periaortic region were provoked in the sessions. Conclusions Acute OTVT was found in 5% of patients after SAVR. Arrhythmia risk stratification by SAECG, Holter ECG, and cardiac MRI should be considered for a long period in patients after SAVR.https://doi.org/10.1002/joa3.12502aortic valve replacementarrhythmialong termperiaorticventricular tachycardia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kentaro Goto Yuichi Ono Yuki Osaka Hidetsugu Nomoto Toru Miyazaki Asami Suzuki Ken Kurihara Takeshi Someya Yoshihide Takahashi Kenichiro Otomo Masahiko Goya Tetsuo Sasano |
spellingShingle |
Kentaro Goto Yuichi Ono Yuki Osaka Hidetsugu Nomoto Toru Miyazaki Asami Suzuki Ken Kurihara Takeshi Someya Yoshihide Takahashi Kenichiro Otomo Masahiko Goya Tetsuo Sasano Incidence of outflow tract ventricular tachycardia long after surgical aortic valve replacement Journal of Arrhythmia aortic valve replacement arrhythmia long term periaortic ventricular tachycardia |
author_facet |
Kentaro Goto Yuichi Ono Yuki Osaka Hidetsugu Nomoto Toru Miyazaki Asami Suzuki Ken Kurihara Takeshi Someya Yoshihide Takahashi Kenichiro Otomo Masahiko Goya Tetsuo Sasano |
author_sort |
Kentaro Goto |
title |
Incidence of outflow tract ventricular tachycardia long after surgical aortic valve replacement |
title_short |
Incidence of outflow tract ventricular tachycardia long after surgical aortic valve replacement |
title_full |
Incidence of outflow tract ventricular tachycardia long after surgical aortic valve replacement |
title_fullStr |
Incidence of outflow tract ventricular tachycardia long after surgical aortic valve replacement |
title_full_unstemmed |
Incidence of outflow tract ventricular tachycardia long after surgical aortic valve replacement |
title_sort |
incidence of outflow tract ventricular tachycardia long after surgical aortic valve replacement |
publisher |
Wiley |
series |
Journal of Arrhythmia |
issn |
1880-4276 1883-2148 |
publishDate |
2021-04-01 |
description |
Abstract Background The peri‐outflow tract region could be the origin of ventricular tachycardia (VT) after aortic valve replacement (AVR). However, the clinical characteristics of outflow tract ventricular tachycardias (OTVTs) after AVR are yet to be clarified. This study investigated the incidence, risk factors, and clinical characteristics of patients with OTVTs after AVR. Methods We retrospectively analyzed the clinical course of 120 patients who had undergone surgical AVR (SAVR) between April 1980 and October 2018. The patients had no ischemic or diagnosed cardiomyopathies other than primary aortic valve diseases. Results Six patients (5.0%) developed OTVTs after SAVR. The average onset was at 10.8 ± 5.7 years after SAVR. All cases of VT arose from the inferior axis and included left and right bundle branch block configuration. Two patients who underwent cardiac magnetic resonance imaging (MRI) had late gadolinium enhancement (LGE) in the midlayer of the left ventricle basal anteroseptal wall. Patients with periaortic VTs had significantly larger left ventricular (LV) diameter at systole, lower LV ejection fraction, higher positive rates of signal‐averaged electrocardiogram (SAECG), and nonsustained VTs on Holter monitoring. On ablation, local fragmented potentials with low voltage zones were observed in accordance with the LGE distribution. Multiple VTs originating from the periaortic region were provoked in the sessions. Conclusions Acute OTVT was found in 5% of patients after SAVR. Arrhythmia risk stratification by SAECG, Holter ECG, and cardiac MRI should be considered for a long period in patients after SAVR. |
topic |
aortic valve replacement arrhythmia long term periaortic ventricular tachycardia |
url |
https://doi.org/10.1002/joa3.12502 |
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