Abstract 20251: Intracoronary Administration of Bone Marrow-Derived Mononuclear Cells and Arrhythmic Events in Patients with Chronic Heart Failure
Introduction: There are continued debates on potential proarrhythmic effects of intracoronary bone marrow-derived progenitor cell (BMC) therapy for treatment of chronic heart failure. Implantable cardioverter defibrillators, a mainstay of heart failure therapy, provide the possibility of validly assessing arrhythmias in patients with chronic heart failure. The aim of this analysis was to assess the arrhythmogenic potential of intracoronary BMC therapy, continuously documented by ICD-stored intracardiac electrograms.
Methods: Matched cohort study of 112 patients receiving intracoronary administration of autologous BMC and 224 heart failure patients, matched for age, gender and left-ventricular ejection fraction, fitted with an ICD.
Results: Within a follow-up period of two years (total patient years-at-risk: 595 years), no significant difference was detected for ICD-stored episodes of ventricular tachycardia (25.0% vs. 27.1% p=0.779), ventricular tachycardia/ventricular fibrillation treated by ATP or ICD shock (15.6% vs. 15.5% p=0.956) or death from arrhythmic cause (4.2% vs. 1.0% p=0.667). Independent predictors of occurrence of major arrhythmic events were parameters of advanced heart failure and a history of ventricular tachycardia; no influence could be detected for BMC administration (HR=1.002; p=0.992).
Conclusions: Intracoronary administration of BMC does not appear to aggravate life-threatening arrhythmias in patients with chronic heart failure.
- © 2010 by American Heart Association, Inc.