Introduction
Ventricular arrhythmia (VA) is an important cause of morbidity and
mortality in patients with mitral valve disease. Several studies have
illustrated the importance of VA as a predictor of sudden cardiac death
in patients with mitral valve disease. 1-5 Though
mitral valve surgery (MVS) has shown significant improvement in heart
failure symptoms and mortality, surgical intervention does not uniformly
eliminate the risk of VA.6-9 Furthermore, valve
surgery itself could be a contributing factor for VA occurrence either
early following surgery or years later.10 The
mechanism of VA in this population includes bundle branch reentry (BBR),
enhanced automaticity, and scar-related reentry. The proximity of the
His bundle to the mitral annulus makes BBR an important mechanism
especially when VA presents early following MVS11,
whereas scar-related reentry tends to present later. Data about the
characteristics and outcomes of VA in patients with prior MVS remains
scant. 10,12-16 Previous studies have investigated VA
ablation in patients with cardiac or valve surgery in general, but not
specifically in those with MVS.10 14Thus, MVS patients represented a minor category in prior reports.
Furthermore, prior studies focused on early postoperative VA and only a
few studies addressed late-onset VA.
We report on a cohort of 31 patients with a prior history of MVS who
were treated with CA for ventricular tachycardia (VT) or premature
ventricular contractions (PVC). We describe the characteristics of
arrhythmia as well as feasibility, safety and outcomes of catheter
ablation procedures in this patient population.