Quality of life improvement after radiofrequency catheter ablation of outflow tract ventricular arrhythmias in patients with structurally normal heart.

摘要

Patients with structurally normal hearts (SNH) suffering from ventricular tachycardia (VT) or frequent premature ventricular contractions (PVCs) are at low risk of sudden cardiac death. Any treatment ameliorates symptoms without a substantial influence on survival.The aim of this study was to prospectively evaluate the health-related quality of life (QoL) of patients with SNH undergoing elective radiofrequency ablation (RFA) of VT or PVCs.Patients scheduled for RFA of VT or PVCs in SNH were enrolled. They underwent 24-h Holter ECG and QoL assessment (SF-36 questionnaire) at baseline and at 3-month follow-up. Results were compared within and between VT and PVCs groups.Among 44 enrolled patients:(i) 23 had VT; (ii) 21 had PVCs with a mean count of 18,711 +/- 10,378 beats/24h. Antiarrhythmic drugs (sotalol, propafenone) were more frequently used in the VT group than in the PVC group. All patients underwent successful RFA with no major complications with 2 cases of early reablation. At follow-up, a significant improvement 6 of 8 domains of SF-36 was observed in the VT and PVCs groups respectively with no significant difference in physical and mental component summary score between both groups.Favourable outcome of radiofrequency ablation in terms of quality of life and safety supports the idea of aggressive treatment of ventricular arrhythmia in patients with structurally normal hearts who are symptomatic and/or prone to cardiomyopathy. Comparable improvement of QoL in patients with PVCs and VT is an additional argument for performing ablation in symptomatic patients with frequent ventricular contractions.