Rapid-rate Non-sustained Ventricular Tachycardias in High-Risk Dilated Cardiomyopathy Patients

Link to article at PubMed

Pacing Clin Electrophysiol. 2020 Jul 31. doi: 10.1111/pace.14027. Online ahead of print.


AIMS: Non-sustained ventricular tachycardia (NSVT) occurs frequently in patients with dilated cardiomyopathy (DCM), especially in high-risk patients. The role of rapid-rate NSVT (RR-NSVT) documented by an implantable cardioverter defibrillator (ICD) in DCM patients has not been fully explored. This study aimed to determine the relationship between RR-NSVT and the occurrence of ventricular tachyarrhythmias (VTAs) in DCM patients with ICD.

METHODS: From December 2000 to December 2017, 136 DCM patients received ICD or cardiac resynchronization therapy defibrillator (CRT-D) implantation for primary or secondary prevention of VTAs. Based on the occurrence of documented RR-NSVT, patients were classified into RR-NSVT (-) or RR-NSVT (+) groups.

RESULT: During the median follow-up of 4.5 years, 50.0% (68/136) of patients experienced ≥ 1 episode, and 25.0% (34/136) of patients experienced ≥ 3 episodes of RR-NSVT. Event-free survival for VTAs was significantly higher in the RR-NSVT (-) group whereas those for heart failure admission and cardiovascular mortality were comparable between groups. In the multivariate cox regression analysis, any RR-NSVT showed a positive association with the occurrence of VTAs (HR: 5.087; 95% CI: 2.374-10.900; p<0.001). In RR-NSVT (+) patients, a cluster (≥ 3 times/6 months) and frequent pattern (≥ 3 runs/day) of RR-NSVT were observed in 42.6% (29/68) and 30.9% (21/68) of patients, respectively, who showed further increased incidence of VTAs.

CONCLUSION: In DCM patients with ICD/CRT-D, 50.0% experienced at least 1 episode of RR-NSVT. RR-NSVT documentation showed a positive association with subsequent occurrence of VTAs, suggesting the importance of constructive arrhythmia management for patients with RR-NSVT. This article is protected by copyright. All rights reserved.

PMID:32735041 | DOI:10.1111/pace.14027

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