Gender differences in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy: Clinical manifestations, electrophysiological properties, substrate characteristics, and prognosis of radiofrequency catheter ablation. (15th January 2017)

• Record Type: Journal Article
• Authors: Lin, Chin-Yu; Chung, Fa-Po; Lin, Yenn-Jiang; Chang, Shih-Lin; Lo, Li-Wei; Hu, Yu-Feng; Tuan, Ta-Chuan; Chao, Tze-Fan; Liao, Jo-Nan; Chang, Yao-Ting; Chen, Yun-Yu; Walia, Rohit; Te, Abigail Louise D.; Yamada, Shinya; Chen, Shih-Ann
• Is Part Of: International journal of cardiology. Volume 227(2017)
• Page Start: 930
• Page End: 937
• Publication Date: 2017-01-15
• Subjects: Arrhythmogenic right ventricular dysplasia/cardiomyopathy -- Gender differences -- Late potential -- Substrate characteristics -- Ventricular arrhythmias; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2016.11.055
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: 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). Methods: Patients 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. Results: A 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. Conclusion: Patients 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.