Ablation for Atrial Fibrillation in Patients With Rare Pathogenic Variants in Cardiomyopathy and Arrhythmia Genes
Rattachement africain : us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Patients with rare, pathogenic cardiomyopathy (CM) and arrhythmia variants can present with atrial fibrillation (AF). The efficacy of AF ablation in these patients is unknown. OBJECTIVE: This study tested the hypotheses that: 1) patients with a pathogenic variant in any CM or arrhythmia gene have increased recurrence following AF ablation; and 2) patients with a pathogenic variant associated with a specific gene group (arrhythmogenic left ventricular CM [ALVC], arrhythmogenic right ventricular CM, dilated CM, hypertrophic CM, or a channelopathy) have increased recurrence. METHODS: We performed a prospective, observational, cohort study of patients who underwent AF catheter ablation and whole exome sequencing. The primary outcome measure was ≥30 seconds of any atrial tachyarrhythmia that occurred after a 90-day blanking period. RESULTS: Among 1,366 participants, 109 (8.0%) had a pathogenic or likely pathogenic (P/LP) variant in a CM or arrhythmia gene. In multivariable analysis, the presence of a P/LP variant in any gene was not significantly associated with recurrence (HR 1.15; 95% CI 0.84-1.60; P = 0.53). P/LP variants in the ALVC gene group, predominantly LMNA, were associated with increased recurrence (n = 10; HR 3.75; 95% CI 1.84-7.63; P < 0.001), compared with those in the arrhythmogenic right ventricular CM, dilated CM, hypertrophic CM, and channelopathy gene groups. Participants with P/LP TTN variants (n = 46) had no difference in recurrence compared with genotype-negative-controls (HR 0.93; 95% CI 0.54-1.59; P = 0.78). CONCLUSIONS: Our results support the use of AF ablation for most patients with rare pathogenic CM or arrhythmia variants, including TTN. However, patients with ALVC variants, such as LMNA, may be at a significantly higher risk for arrhythmia recurrence.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Ablation for Atrial Fibrillation in Patients With Rare Pathogenic Variants in Cardiomyopathy and Arrhythmia Genes
- Date Crossref
- 01/11/2024
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
Vanderbilt University Medical Center Division of Cardiovascular Medicine pays non établi dans la noticeÉtablissement de santé
-
Vanderbilt University pays non établi dans la noticeUniversité ou école supérieure
-
Stanford Health Care pays non établi dans la noticeÉtablissement de santé
-
Children's Health Council pays non établi dans la noticeInstitution
-
Massachusetts General Hospital Division of Cardiovascular Medicine pays non établi dans la noticeÉtablissement de santé
-
Monroe Carell Jr. Children's Hospital pays non établi dans la noticeÉtablissement de santé
-
Novartis (United States) pays non établi dans la noticeEntreprise
-
Genome Medical pays non établi dans la noticeInstitution
-
Stanford Children Health pays non établi dans la noticeInstitution
-
Vanderbilt Children's Hospital Division of Pediatric Cardiology pays non établi dans la noticeÉtablissement de santé
-
Novartis Institute for Biomedical Research pays non établi dans la noticeStructure de recherche
Division of Cardiovascular Medicine — Vanderbilt University Medical Center, Vanderbilt University et Stanford Health Care, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.