The Reverse Structure Remodeling Effect Of Radiofrequency Ablation On Left Ventricle Impaired Function In Patients With Ventricular Arrhythmias Originating From The Outflow Tract

ObjectiveTo investigate the reverse structure remodeling effect of radiofrequency ablation on left ventricle impaired function in patients with ventricular arrhythmias originating from the outflow tract.MethodsPARTⅠ:This prospective study including 22 patients who suffered from outflow tract ventricular arrhythmia[premature ventricular contraction（PVC）,ventricular tachycardia（VT）]and received radiofrequency ablation treatment in our center.Transthoracic echocardiography was used to evaluate cardiac systolic function[left ventricular end diastolic dimension（LVDd）,left ventricular end systolic dimension（LVSd）|,left ventricular ejection fraction（LVEF）]at the time before ablation procedure,then the 3^rd day,1^st,2^nd,3^rd,6^th and 12^th month after ablation procedure,respectively.Holter monitoring was performed at very follow-up time point.PARTⅡ:This prospective observational study including 22 patients who suffered from outflow tract premature ventricular contraction and outflow tract ventricular tachycardia received radiofrequency ablation treatment in our center.Transthoracic echocardiography was used to evaluate cardiac diastolic function[the ratio of early transmitral flow velocity（E）to the ratio of later transmitral flow velocity（A）（E/A）,early mitral annular velocity（e’）,the ratio of early transmitral flow velocity（E）to early mitral annular velocity（e’）（E/e’）]at the 3^rd day,1^st,2^nd,3^rd,6^th and 12^th month after ablation procedure,respectively.Finally,we investigated the outcome of left ventricle reverse remodeling after radiofrequency ablation in patients with impairment in cardiac function caused by outflow tract ventricular arrhythmias.Holter monitoring was performed at very follow-up time point.ResultsPARTⅠ:This study included 22 patients[11 men,median age 38（27-49）years old,who suffered from outflow tract ventricular arrhythmia.Of them,21 patients suffered from PVC and nonsustained VT（NSVT）,1 patients suffered from sustained VT（SVT）.Ablation was successful in all patients.There was no significant difference of LVDd,LVSd and LVEF between the 3^rd day after ablation procedure and baseline（57.2±5.2 mm vs.56.7±4.2 mm,41.2±6.3 mm vs.40.5±3.7 mm,54.4±7.6%vs.54.7±4.7%,P all>0.05,respectively）.There was significant difference of LVDd,LVSd and LVEF between the 1^st month after ablation procedure and baseline(53.5±3.2 mm vs.56.7±4.2 mm,36.5±4.3 mm vs.40.5±3.7 mm,59.4±6.7%vs.54.7±4.7%,P all<0.05,respectively.There was also significant difference of LVDd,LVSd and LVEF between the 2^nd,3^rd,6^th and 12^th month after ablation procedure and baseline and the 3^rd day after procedure（P all<0.05,respectively）.There was no significant difference of LVDd,LVSd and LVEF between the 3^rd or 6^th month and the1^st or 2^nd month,P all>0.05,respectively.PVC reoccurred in one patient,repeated ablation procedure was successful.Follow-up was lost in three patients at the 12^thh month after ablation procedure.PARTⅡ:There was no significant difference in E/A at 1^st,2^nd,3^rd,6^th and 12^thh month（1.2±0.6,0.9±0.2,0.9±0.2,1.0±0.3,1.0±0.3）after ablation procedure compared with baseline（1.2±0.5）.There was significant difference of e’at the 3^rd,6^thh and 12^th month（8.3±1.2,8.5±2.2 and 8.2±1.5）after ablation procedure compared with 3^rd days（6.1±1.9）after ablation procedure,respectively,P all<0.05.There was also significant difference of E/e’at the1^st,2^nd,3^rd,6^th and 12^th month（8.5±1.6,7.6±1.1,6.6±1.5,6.9±1.3 and 7.1±0.8）after ablation procedure compared with 3^rd days（11.4±5.4）after ablation procedure,respectively,P all<0.05.PVC reoccurred in one patient,repeated ablation procedure was successful.Follow-up was lost in three patients at the 12^th month after ablation procedure.ConclusionsThe structure remodeling of impaired left ventricle function was rervsed by radiofrequency ablation in patients with outflow tract ventricular arrhythmias.