Vol.:(0123456789) 1 3 Journal of Interventional Cardiac Electrophysiology https://doi.org/10.1007/s10840-021-01019-6 Physical activity volume in patients with arrhythmogenic cardiomyopathy is associated with recurrence after ventricular tachycardia ablation Pasquale Vergara 1  · Luigi Pannone 1  · Francesco Calvo 1  · Giulio Falasconi 1  · Luca Foppoli 1  · Manuela Cireddu 1  · Giuseppe D’Angelo 1  · Luca Limite 1  · Antonio Boccellino 1  · Anna Palmisano 2  · Cristina Capogrosso 3  · Stefano Stella 3  · Antonio Esposito 2,4  · Eustachio Agricola 3,4  · Simone Gulletta 1  · Paolo Della Bella 1 Received: 17 March 2021 / Accepted: 2 June 2021 © Springer Science+Business Media, LLC, part of Springer Nature 2021 Abstract Purpose To assess the role of intense physical activity (PA) on recurrence after ventricular tachycardia (VT) ablation in arrhythmogenic cardiomyopathy (ACM). Methods We retrospectively analyzed 63 patients with defnite diagnosis of ACM who underwent to catheter ablation (CA) of VT. PA was quantifed in METs per week by IPAQ questionnaire in 51 patients. VT-free survival time after ablation was analyzed by Kaplan–Meier’s curves. Results The weekly amount of PA was higher in patients with VT recurrence (2303.1 METs vs 1043.5 METs, p = 0.042). The best cutof to predict VT recurrence after CA was 584 METs/week (AUC = 0.66, sensibility = 85.0%, specifcity = 45.2%). Based on this cutof, 34 patients were defned as high level athletes (Hi-PA) and 17 patients as low-level athletes (Lo-PA). During a median follow-up of 32.0 months (11.5–65.5), 22 patients (34.9%) experienced VT recurrence. Lo-PA patients had a longer VT-free survival, compared with Hi-PA patients (82.4% vs 50.0%, log-rank p = 0.025). At Cox multivariate analysis, independent predictors of the VT recurrence were PA ≥ 584 METs/week (Hi-PA) (HR = 2.61, CI 95% 1.03–6.58, p = 0.04) and late potential (LP) abolition (HR = 0.38, CI 95% 0.16–0.89, p = 0.03). Conclusions PA ≥ 584 METs/week and LP abolition were independent predictors of VT recurrence after ablation. Keywords Ventricular tachycardia · Catheter ablation · Arrhythmogenic cardiomyopathy · Right ventricular dysplasia · Physical activity Abbreviations AMC Arrhythmogenic cardiomyopathy CA Catheter ablation LV Left ventricle (LV) PA Physical activity RV Right ventricle SCD Sudden cardiac death TWI T-wave inversion VTT Ventricular tachycardia 1 Introduction Arrhythmogenic cardiomyopathy (ACM) is a genetic disease associated with an increased risk of sudden cardiac death (SCD), mainly due to ventricular tachycardia (VT) originat- ing from right ventricular (RV) scar tissue [1]. Several gene mutations have been associated with the disease, most of them coding for desmosomes, structures involved in intercel- lular junctions. The disruption of the intercellular structures is thought to play a role in the pathogenesis of the disease. Previous studies showed a link between physical activity (PA) and ACM manifestations: vigorous PA impairs myo- cardial function in patients with ACM and the amount of Pasquale Vergara and Luigi Pannone are shared frst authors * Pasquale Vergara pasqualevergara@hotmail.com 1 Arrhythmology Unit and Clinical Electrophysiology Laboratories, Ospedale San Rafaele, IRCCS San Rafaele Scientifc Institute, Milan, Italy 2 Radiology Unit, Ospedale San Rafaele, Milan, Italy 3 Cardiac Imaging Unit, Ospedale San Rafaele, Milan, Italy 4 Vita-Salute University, Milan, Italy