Gender differences in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy: Clinical manifestations, electrophysiological properties, substrate characteristics, and prognosis of radiofrequency catheter ablation

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• 作者：Chin-Yu Lin^a ; ^b ; ^c ; ¹ ; Fa-Po Chung^a ; ^b ; ¹ ; Yenn-Jiang Lin^a ; ^b ; ^{linyennjiang@gmail.com} ; Shih-Lin Chang^a ; ^b ; Li-Wei Lo^a ; ^b ; Yu-Feng Hu^a ; ^b ; Ta-Chuan Tuan^a ; ^b ; Tze-Fan Chao^a ; ^b ; Jo-Nan Liao^a ; ^b ; Yao-Ting Chang^a ; ^b ; Yun-Yu Chen^a ; ^d ; Rohit Walia^a ; Abigail Louise D. Te^a ; Shinya Yamada^a ; Shih-Ann Chen^a ; ^b
• 关键词：Arrhythmogenic right ventricular dysplasia/cardiomyopathy ; Gender differences ; Late potential ; Substrate characteristics ; Ventricular arrhythmias
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：15 January 2017
• 年：2017
• 卷：227
• 期：Complete
• 页码：930-937
• 全文大小：1190 K
• 卷排序：227

文摘

Gender differences in the penetrance and clinical expression of genetic mutations have been reported in patients with arrhythmogenic right ventricular (RV) dysplasia/cardiomyopathy (ARVD/C). Our study aimed at clarifying the impact of gender on ventricular substrates and clinical outcomes after radiofrequency catheter ablation (RFCA).MethodsPatients with ARVD/C underwent RFCA for drug-refractory ventricular arrhythmias (VAs) were consecutively enrolled. Baseline characteristics, electrocardiograms, ventricular substrates, and VA recurrences after RFCA were extracted for comparison between genders.ResultsA total of 70 consecutive unselected patients with definite ARVD/C (36 men [51%], age 45 ± 14 years) were studied. Male patients had a higher incidence of sustained ventricular tachycardia and ventricular fibrillation or sudden cardiac arrest as initial manifestations. Electroanatomical mapping demonstrated that men with ARVD/C had a larger epicardial RV unipolar low-voltage zone, a larger endocardial and epicardial area with late potentials, and longer local abnormal ventricular activity. Cox regression analysis demonstrated that gender and late potential area predicted the recurrences of VAs.ConclusionPatients with ARVD/C displayed different characteristics of VAs and substrate properties between men and women. Male gender and the presence of larger area of abnormal electrograms independently predicted VA recurrences after RFCA.