Abstract 2678: Gender and Age Differences in Idiopathic Ventricular Arrhythmias
Background: The prevalence, gender- and age-related differences, ablation success rate and inter-relationship between the origins of the idiopathic ventricular arrhythmias (I-VAs) have not been clarified.
Methods: We studied 625 consecutive patients with I-VAs (315 male, 54±17years) who underwent catheter ablation. The VA origin was defined as the site where the earliest ventricular activation was recorded and/or perfect pace map was obtained. The patients with ventricular tachycardia (VT; n=218) and ventricular premature contractions (VPCs; n=405) were divided into 5 groups based on the VA origin; 1) OT-VAs (outflow tract VAs), 2) IT-VAs (inflow tract VAs), 3) LV Sep-VAs (left ventricular infero-septum VAs; also known as verapamil-sensitive VT), 4) LV other-VAs (LV origins excluding LVSep-VAs), and 5) RV-VAs (right ventricular VAs).
Results (See Table⇓): RVOT VAs in women were 1.5 times more frequent than in men, while LVOT VAs were more frequent in men. The prevalence of I-VAs with an origin in the LVOT increased with age compared to that in the RVOT. The ablation success rate of RVOT VAs was significantly higher than that of LVOT VAs (290/331 [88%] vs. 92/159 [58%], p<0.0001). The mean age of the patients with MA free wall VAs was significantly higher than that of TA free wall VAs (51±18 years vs. 62±14 years, p<0.05). A multivariable logistic regression showed that the age of the patient emerged as the most valuable predictor of a successful ablation of OT-VAs (p=0.03) and IT-VAs (p=0.004).
Conclusions: Distinct gender and age differences were found in the incidence of I-VAs according to their site of origin. The ablation success rate of I-VAs was dependent on the age of the patient.