Background
Idiopathic ventricular arrhythmias (IVAs) refers to ventricular tachycardias or premature ventricular contractions (PVCs) occurring in the absence of myocardial scar in structurally normal hearts. Strain by speckle tracking echocardiography (STE) can detect subtle changes in myocardial function, and STE in the assessment of IVA patients has not been assessed. We evaluated STE in IVA patients (at baseline, and following radiofrequency ablation (RFA)), to identify if IVA demonstrates abnormality in myocardial substrate. Method(s)
Using STE, global longitudinal strain (GLS), mechanical dispersion (MD), and delta contraction duration (DCD) were measured in 53 consecutive IVA patients undergoing ablation, and compared to 53 healthy controls. Patients were followed up post ablation for STE parameters. Success of IVA ablation was determined by multi- day Holter monitoring at follow-up. Result(s)
IVA patients had impaired GLS (-19.6 ± 3.3% versus -21.7 ± 1.6%, p=0.002), increased MD (43 ± 11.6ms versus 33.9 ± 7.5ms), and prolonged DCD (133.5 ± 19.2ms versus 71.6 ± 10.5ms) compared to controls, at baseline. At follow-up (13 ± 7 months), 43 patients (81%) remained free of IVA with normalisation of GLS and MD; however, DCD remained prolonged at follow-up compared to controls (102.1 ± 17.7ms versus 71.7 ± 10.5ms). In patients without cure (n=10, 19%), GLS, MD, and DCD significantly worsened at follow-up. Conclusion(s)
Patients with IVAs manifest subclinical LV dysfunction and impaired myocardial mechanics. These changes are only partially reversed in patients treated with RFA, indicating the need for ongoing active surveillance.

Speckle-tracking strain echocardiography in the assessment of myocardial mechanics in patients with idiopathic ventricular arrhythmias

ECHO ASIA is organized by Asian-Pacific Association of Echocardiography (AAE). The meeting combines the basic echocardiography training curriculum and the state-of-the-art lectures/scientific sessions provided by international as well as Asian-Pacific experts. The meeting is a unique forum where scientists from many countries in the Asian-Pacific region who are involved in the field of Doppler echocardiography gather together to exchange knowledge and skills. Various internationally distinguished faculties consent to present their findings and reveal their clinical experiences in ECHO ASIA.