High Risk of Ventricular Arrhythmias in Patients With Nonischemic Dilated Cardiomyopathy Presenting With Syncope

Phang, Robert S.; Kang, David; Tighiouart, Hocine; Estes, N.A. Mark; Link, Mark S.

doi:10.1016/j.amjcard.2005.08.063

Cited by 20 publications

(10 citation statements)

References 25 publications

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“…AR‐DCM phenotype was diagnosed by the presence of 1 of the following: (1) unexplained syncope (likely due to ventricular tachyarrhythmia),2, 14, 15, 16 (2) rapid nonsustained ventricular tachycardia (NSVT) defined as ≥5 consecutive ventricular beats,17 lasting <30 seconds, with a rate ≥150/min on 24‐hour Holter monitoring,18 (3) ≥1000 premature ventricular contractions (PVCs) in 24 hours1 or (4) ≥50 couplets in 24 hours 19. ICD implantation had been performed for primary prevention in selected patients with DCM considered at high risk for SCD (ie, persistent LV dysfunction with LVEF ≤35% and New York Heart Association class II or III while being treated with optimal medical therapy).…”

Section: Methodsmentioning

confidence: 99%

Arrhythmogenic Phenotype in Dilated Cardiomyopathy: Natural History and Predictors of Life‐Threatening Arrhythmias

Spezzacatene

Sinagra

Merlo

et al. 2015

JAHA

111

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BackgroundPatients with dilated cardiomyopathy (DCM) may present with ventricular arrhythmias early in the disease course, unrelated to the severity of left ventricular dysfunction. These patients may be classified as having an arrhythmogenic DCM (AR‐DCM). We investigated the phenotype and natural history of patients with AR‐DCM.Methods and ResultsTwo hundred eighty‐five patients with a recent diagnosis of DCM (median duration of the disease 1 month, range 0 to 7 months) and who had Holter monitoring at baseline were comprehensively evaluated and followed for 107 months (range 29 to 170 months). AR‐DCM was defined by the presence of ≥1 of the following: unexplained syncope, rapid nonsustained ventricular tachycardia (≥5 beats, ≥150 bpm), ≥1000 premature ventricular contractions/24 hours, and ≥50 ventricular couplets/24 hours, in the absence of overt heart failure. The primary end points were sudden cardiac death (SCD), sustained ventricular tachycardia (SVT), or ventricular fibrillation (VF). The secondary end points were death from congestive heart failure or heart transplantation. Of the 285 patients, 109 (38.2%) met criteria for AR‐DCM phenotype. AR‐DCM subjects had a higher incidence of SCD/SVT/VF compared with non–AR‐DCM patients (30.3% vs 17.6%, P=0.022), with no difference in the secondary end points. A family history of SCD/SVT/VF and the AR‐DCM phenotype were statistically significant and cumulative predictors of SCD/SVT/VF.ConclusionsOne‐third of DCM patients may have an arrhythmogenic phenotype associated with increased risk of arrhythmias during follow‐up. A family history of ventricular arrhythmias in DCM predicts a poor prognosis and increased risk of SCD.

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Section: Methodsmentioning

confidence: 99%

Arrhythmogenic Phenotype in Dilated Cardiomyopathy: Natural History and Predictors of Life‐Threatening Arrhythmias

Spezzacatene

Sinagra

Merlo

et al. 2015

JAHA

111

View full text Add to dashboard Cite

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“…116,117 In a singlecenter study performed two decades ago, of 491 patients with advanced heart failure due to coronary artery disease (48%) and NICM (51%), 60 patients (12%) had syncope. 116 During a mean follow-up of 1 year, the incidence of sudden death was higher in the syncope group compared with those patients without syncope (syncope: 45% vs no syncope: 12%; P<.00001).…”

Section: Discussionmentioning

confidence: 99%

HRS/ACC/AHA Expert Consensus Statement on the Use of Implantable Cardioverter-Defibrillator Therapy in Patients Who Are Not Included or Not Well Represented in Clinical Trials

et al. 2014

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“…46 I A An ICD should be considered in patients with unexplained syncope a with systolic impairment, but without a current indication for ICD, to reduce the risk of sudden death. 27,28,359,360 IIa C Instead of an ICD, an ILR may be considered in patients with recurrent episodes of unexplained syncope a with systolic impairment, but without a current indication for ICD.…”

Section: Recommendationsmentioning

confidence: 99%

“…358 Data from observational studies in selected cohorts show a high rate of occurrence of ventricular arrhythmias, ICD discharge, and death in patients with a history of unexplained syncope but, owing to a lack of control groups, are unable to show the benefit of an ICD. 27,28,359,360 This Task Force believes that an ICD should be considered in patients with unexplained syncope with systolic impairment but without a current indication for ICD to reduce the risk of sudden death.…”

Section: Iib C Additional Advice and Clinical Perspectivesmentioning

confidence: 99%

2018 ESC Guidelines for the diagnosis and management of syncope

Parikka¹

2018

Revista Española de Cardiología (English Edition)

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High Risk of Ventricular Arrhythmias in Patients With Nonischemic Dilated Cardiomyopathy Presenting With Syncope

Cited by 20 publications

References 25 publications

Arrhythmogenic Phenotype in Dilated Cardiomyopathy: Natural History and Predictors of Life‐Threatening Arrhythmias

Arrhythmogenic Phenotype in Dilated Cardiomyopathy: Natural History and Predictors of Life‐Threatening Arrhythmias

HRS/ACC/AHA Expert Consensus Statement on the Use of Implantable Cardioverter-Defibrillator Therapy in Patients Who Are Not Included or Not Well Represented in Clinical Trials

2018 ESC Guidelines for the diagnosis and management of syncope

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