Ventricular arrhythmias following balloon-expandable transcatheter pulmonary valve replacement in the native right ventricular outflow tract.

Autor: Barfuss SB; Department of Pediatrics, Division of Cardiology, University of Utah and Primary Children's Hospital, Salt Lake City, Utah, USA., Samayoa JC; Department of Pediatrics, Division of Cardiology, University of Washington and Seattle Children's Hospital, Seattle, Washington, USA., Etheridge SP; Department of Pediatrics, Division of Cardiology, University of Utah and Primary Children's Hospital, Salt Lake City, Utah, USA., Pilcher TA; Department of Pediatrics, Division of Cardiology, University of Utah and Primary Children's Hospital, Salt Lake City, Utah, USA., Asaki SY; Department of Pediatrics, Division of Cardiology, University of Utah and Primary Children's Hospital, Salt Lake City, Utah, USA., Ou Z; Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, Utah, USA., Boucek DM; Department of Pediatrics, Division of Cardiology, University of Utah and Primary Children's Hospital, Salt Lake City, Utah, USA., Martin MH; Department of Pediatrics, Division of Cardiology, University of Utah and Primary Children's Hospital, Salt Lake City, Utah, USA., Gray RG; Department of Pediatrics, Division of Cardiology, University of Utah and Primary Children's Hospital, Salt Lake City, Utah, USA., Niu MC; Department of Pediatrics, Division of Cardiology, University of Utah and Primary Children's Hospital, Salt Lake City, Utah, USA.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2023 Jan 29. Date of Electronic Publication: 2023 Jan 29.
DOI: 10.1002/ccd.30560
Abstrakt: Background: Ventricular arrhythmia incidence in children and adolescents undergoing transcatheter pulmonary valve replacement (TPVR) within the native right ventricular outflow tract (nRVOT) is unknown. We sought to describe the incidence, severity, and duration of ventricular arrhythmias and identify associated risk factors in this population.
Methods: This was a retrospective cohort study of 78 patients <21 years of age who underwent TPVR within the nRVOT. Patients were excluded for pre-existing ventricular arrhythmia or antiarrhythmic use. Study variables included surgical history, valve replacement indication, valve type/size, and ventricular arrhythmia. Univariable logistic regression models were used to evaluate factors associated with ventricular arrhythmias, followed by subset analyses.
Results: Nonsustained ventricular arrhythmia occurred in 26/78 patients (33.3%). The median age at the procedure was 10.3 years (interquartle range [IQR]: 6.5, 12.8). Compared with other nRVOT types, surgical repair with transannular patch was protective against ventricular arrhythmia incidence: odds ratio (OR): 0.35 (95% confidence interval [CI], 0.13-0.95). Patient weight, valve type/size, number of prestents, and degree of stent extension into the RVOT were not associated with ventricular arrhythmia occurrence. Beta blocker was started in 16/26 (61.5%) patients with ventricular arrhythmia. One additional patient was lost to follow-up. The median beta blocker duration was 46 days (IQR 42, 102). Beta blocker was discontinued in 10 patients by 8-week follow-up and in the remaining four by 9 months.
Conclusions: Though common after balloon-expandable TPVR within the nRVOT, ventricular arrhythmias were benign and transient. Antiarrhythmic medications were successfully discontinued in the majority at 6- to 8-week follow-up, and in all patients by 20 months.
(© 2023 Wiley Periodicals LLC.)
Databáze: MEDLINE
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