Journal of Yeungnam Medical Science

영남대 의대 학술지 편집위원회 (Yeungnam University College of Medicine, Yeungnam University Institute Medical Science)
권호 표지
DOI QR코드

DOI QR Code

Meta-analysis on risk stratification of malignant ventricular tachyarrhythmic events in arrhythmogenic right ventricular cardiomyopathy

  • Roh, Young-Eun (Medical Research Institute of Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Jang, Hyun Ji (Medical Research Institute of Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Cho, Min-Jung (Medical Research Institute of Pusan National University Hospital, Pusan National University School of Medicine)
  • 투고 : 2017.10.12
  • 심사 : 2017.10.25
  • 발행 : 2017.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a cardiomyopathy characterized by predominant right ventricular fibro-fatty replacement, right ventricular dysfunction and ventricular arrhythmias. It is a rare but important cause of sudden cardiac death in children and young adults. A meta-analysis on risk stratification of major ventricular tachyarrhythmic events indicating the need for implantable cardioverter defibrillator therapy in ARVC was performed. Methods: The pubmed database was searched from its inception to May 2015. Of the 433 citations identified, 12 were included in this meta-analysis. Data regarding major ventricular tachyarrhythmic events were retrieved in 817 subjects from the studies. For the variables, a combined odds ratio (OR) was calculated using a fixed-effects meta-analysis. Results: Extensive right ventricular dysfunction (OR, 2.44), ventricular late potential (OR, 1.66), inducible ventricular tachyarrhythmia during electrophysiology study (OR, 3.67), non-sustained ventricular tachycardia (OR, 3.78), and history of fatal event/sustained VT (OR, 5.66) identified as significant risk factors (p<0.0001). Conclusion: This meta-analysis shows that extensive right ventricular dysfunction, ventricular late potential, inducible ventricular tachyarrhythmia during electrophysiological study, non-sustained ventricular tachycardia, and history of sustained ventricular tachycardia/fibrillation are consistently reported risk factors of major ventricular tachyarrhythmic events indicating implantable cardioverter defibrillator therapy in patients with ARVC.

키워드

참고문헌

  1. Thiene G, Nava A, Corrado D, Rossi L, Pennelli N. Right ventricular cardiomyopathy and sudden death in young people. N Engl J Med 1988;318:129-33. https://doi.org/10.1056/NEJM198801213180301
  2. Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol 2003;42:1959-63. https://doi.org/10.1016/j.jacc.2003.03.002
  3. Holst AG, Winkel BG, Theilade J, Kristensen IB, Thomsen JL, Ottesen GL, et al. Incidence and etiology of sports-related sudden cardiac death in Denmark--implications for preparticipation screening. Heart Rhythm 2010;7:1365-71. https://doi.org/10.1016/j.hrthm.2010.05.021
  4. Corrado D, Leoni L, Link MS, Della Bella P, Gaita F, Curnis A, et al. Implantable cardioverter-defibrillator therapy for prevention of sudden death in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia. Circulation 2003;108:3084-91. https://doi.org/10.1161/01.CIR.0000103130.33451.D2
  5. Wichter T, Paul M, Wollmann C, Acil T, Gerdes P, Ashraf O, et al. Implantable cardioverter/defibrillator therapy in arrhythmogenic right ventricular cardiomyopathy: single-center experience of long-term follow-up and complications in 60 patients. Circulation 2004;109:1503-8. https://doi.org/10.1161/01.CIR.0000121738.88273.43
  6. Piccini JP, Dalal D, Roguin A, Bomma C, Cheng A, Prakasa K, et al. Predictors of appropriate implantable defibrillator therapies in patients with arrhythmogenic right ventricular dysplasia. Heart Rhythm 2005;2:1188-94. https://doi.org/10.1016/j.hrthm.2005.08.022
  7. Pezawas T, Stix G, Kastner J, Schneider B, Wolzt M, Schmidinger H. Ventricular tachycardia in arrhythmogenic right ventricular dysplasia/cardiomyopathy: clinical presentation, risk stratification and results of long-term follow-up. Int J Cardiol 2006;107:360-8. https://doi.org/10.1016/j.ijcard.2005.03.049
  8. Corrado D, Calkins H, Link MS, Leoni L, Favale S, Bevilacqua M, et al. Prophylactic implantable defibrillator in patients with arrhythmogenic right ventricular cardiomyopathy/ dysplasia and no prior ventricular fibrillation or sustained ventricular tachycardia. Circulation 2010;122:1144-52. https://doi.org/10.1161/CIRCULATIONAHA.109.913871
  9. Bhonsale A, James CA, Tichnell C, Murray B, Gagarin D, Philips B, et al. Incidence and predictors of implantable cardioverter-defibrillator therapy in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy undergoing implantable cardioverter-defibrillator implantation for primary prevention. J Am Coll Cardiol 2011;58:1485-96. https://doi.org/10.1016/j.jacc.2011.06.043
  10. Schuler PK, Haegeli LM, Saguner AM, Wolber T, Tanner FC, Jenni R, et al. Predictors of appropriate ICD therapy in patients with arrhythmogenic right ventricular cardiomyopathy:long term experience of a tertiary care center. PLoS One 2012;7:e39584. https://doi.org/10.1371/journal.pone.0039584
  11. Battipaglia I, Scalone G, Macchione A, Pinnacchio G, Laurito M, Milo M, et al. Association of heart rate variability with arrhythmic events in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia. Circ J 2012;76:618-23. https://doi.org/10.1253/circj.CJ-11-1052
  12. Santangeli P, Dello Russo A, Pieroni M, Casella M, Di Biase L, Burkhardt JD, et al. Fragmented and delayed electrograms within fibrofatty scar predict arrhythmic events in arrhythmogenic right ventricular cardiomyopathy: results from a prospective risk stratification study. Heart Rhythm 2012;9:1200-6. https://doi.org/10.1016/j.hrthm.2012.03.057
  13. Canpolat U, Kabakci G, Aytemir K, Dural M, Sahiner L, Yorgun H, et al. Fragmented QRS complex predicts the arrhythmic events in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia. J Cardiovasc Electrophysiol 2013;24:1260-6. https://doi.org/10.1111/jce.12202
  14. Link MS, Laidlaw D, Polonsky B, Zareba W, McNitt S, Gear K, et al. Ventricular arrhythmias in the North American multidisciplinary study of ARVC: predictors, characteristics, and treatment. J Am Coll Cardiol 2014;64:119-25. https://doi.org/10.1016/j.jacc.2014.04.035
  15. Ruiz-Salas A, Cabrera-Bueno F, Garcia-Pinilla JM, Barrera-Cordero A, Pena-Hernandez J, Fernandez-Pastor J, et al. Longterm prognosis of patients with arrhythmogenic right ventricular cardiomyopathy and implantable defibrillator. Int J Cardiol 2014;174: 794-6. https://doi.org/10.1016/j.ijcard.2014.04.123
  16. Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M, et al. Guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Executive summary. Rev Esp Cardiol 2006;59:1328.
  17. Chung FP, Li HR, Chong E, Pan CH, Lin YJ, Chang SL, et al. Seasonal variation in the frequency of sudden cardiac death and ventricular tachyarrhythmia in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy: the effect of meteorological factors. Heart Rhythm 2013;10:1859-66. https://doi.org/10.1016/j.hrthm.2013.09.069
  18. Roguin A, Bomma CS, Nasir K, Tandri H, Tichnell C, James C, et al. Implantable cardioverter-defibrillators in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy. J Am Coll Cardiol 2004;43:1843-52. https://doi.org/10.1016/j.jacc.2004.01.030
  19. Marcus FI, Fontaine GH, Guiraudon G, Frank R, Laurenceau JL, Malergue C, et al. Right ventricular dysplasia: a report of 24 adult cases. Circulation 1982;65:384-98. https://doi.org/10.1161/01.CIR.65.2.384
  20. Sen-Chowdhry S, Lowe MD, Sporton SC, McKenna WJ. Arrhythmogenic right ventricular cardiomyopathy: clinical presentation, diagnosis, and management. Am J Med 2004;117:685-95. https://doi.org/10.1016/j.amjmed.2004.04.028
  21. Sen-Chowdhry S, Prasad SK, Syrris P, Wage R, Ward D, Merrifield R, et al. Cardiovascular magnetic resonance in arrhythmogenic right ventricular cardiomyopathy revisited: comparison with task force criteria and genotype. J Am Coll Cardiol 2006;48:2132-40. https://doi.org/10.1016/j.jacc.2006.07.045
  22. Gemayel C, Pelliccia A, Thompson PD. Arrhythmogenic right ventricular cardiomyopathy. J Am Coll Cardiol 2001;38:1773-81. https://doi.org/10.1016/S0735-1097(01)01654-0
  23. Blomstrom-Lundqvist C, Olsson SB, Edvardsson N. Followup by repeated signal-averaged surface QRS in patients with the syndrome of arrhythmogenic right ventricular dysplasia. Eur Heart J 1989;10(Suppl D):54-60.
  24. Turrini P, Angelini A, Thiene G, Buja G, Daliento L, Rizzoli G, et al. Late potentials and ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy. Am J Cardiol 1999;83:1214-9. https://doi.org/10.1016/S0002-9149(99)00062-4
  25. Migliore F, Zorzi A, Michieli P, Perazzolo Marra M, Siciliano M, Rigato I, et al. Prevalence of cardiomyopathy in Italian asymptomatic children with electrocardiographic T-wave inversion at preparticipation screening. Circulation 2012;125:529-38. https://doi.org/10.1161/CIRCULATIONAHA.111.055673
  26. Wichter T, Paul M, Wollmann C, Acil T, Gerdes P, Ashraf O, et al. Implantable cardioverter/defibrillator therapy in arrhythmogenic right ventricular cardiomyopathy: single-center experience of long-term follow-up and complications in 60 patients. Circulation 2004;109:1503-8. https://doi.org/10.1161/01.CIR.0000121738.88273.43
  27. Basso C, Corrado D, Bauce B, Thiene G. Arrhythmogenic right ventricular cardiomyopathy. Circ Arrhythm Electrophysiol 2012;5:1233-46. https://doi.org/10.1161/CIRCEP.111.962035
  28. Hulot JS, Jouven X, Empana JP, Frank R, Fontaine G. Natural history and risk stratification of arrhythmogenic right ventricular dysplasia/cardiomyopathy. Circulation 2004;110:1879-84. https://doi.org/10.1161/01.CIR.0000143375.93288.82
  29. Dalal D, Nasir K, Bomma C, Prakasa K, Tandri H, Piccini J, et al. Arrhythmogenic right ventricular dysplasia: a United States experience. Circulation 2005;112:3823-32. https://doi.org/10.1161/CIRCULATIONAHA.105.542266
  30. Marcus FI, Fontaine GH, Frank R, Gallagher JJ, Reiter MJ. Long-term follow-up in patients with arrhythmogenic right ventricular disease. Eur Heart J 1989;10(Suppl D):68-73. https://doi.org/10.1093/eurheartj/10.suppl_D.68