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.