Prognostic Significance of Nonsustained Ventricular Tachycardia Episodes Occurring Early After Implantable Cardioverter-Defibrillator Implantation Among Patients With Left Ventricular Dysfunction

Jiménez‐Candil, Javier; Hernández, Jesús; Perdiguero, Pedro; Martín, Ana; Moríñigo, José Luis; Bravo, Loreto; Duran, O.; Sánchez, Pedro L.

doi:10.1016/j.amjcard.2016.08.015

Cited by 15 publications

(14 citation statements)

References 20 publications

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“…This finding is in consonance with those of other researchers. 31 - 35 Left ventricular ejection fraction less than 35% has been stated to be the cutoff for high risk of sudden cardiac death among HF patients. However, patients with moderately reduced LVEF may still be at risk of sudden cardiac death based on the findings of Zhao et al 31 Conversely, Zorzi et al 34 suggest that the incidence of Holter ECG–detected ventricular arrhythmias was more among HF patients with LVEF <35% and not much of ventricular arrhythmias were detected in patients with LVEF >35%.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Echocardiographic Predictors of Arrhythmias Detected With 24-Hour Holter Electrocardiography Among Hypertensive Heart Failure Patients in Nigeria

Mene-Afejuku

Balogun

Akintomide

et al. 2017

Clin Med Insights Cardiol

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Background:Hypertensive heart failure (HHF) is the commonest form of heart failure in Nigeria. There is paucity of data in Nigeria on 24-hour Holter electrocardiography (24-HHECG) and important predictors of arrhythmias among HHF patients.Objectives:To determine the 24-HHECG characteristics among HHF patients. To determine the clinical and echocardiographic predictors of arrhythmias detected using 24-HHECG among HHF patients.Methods:A total of 100 HHF patients as well as 50 age-matched and sex-matched apparently healthy controls were prospectively recruited over a period of 1 year. They all had baseline laboratory tests, echocardiography, and 24-HHECG.Results:Hypertensive heart failure patients had significantly higher counts of premature ventricular contractions (PVCs) than the controls (P ≤ .001). Ventricular tachycardia (VT) was recorded in 29% of HHF patients as compared with controls who had no VT on 24-HHECG. The standard deviation of all normal to normal sinus RR intervals over 24 hours (SDNN) was abnormally reduced among HHF patients when compared with controls (P = .046). There was positive correlation between atrial fibrillation (AF) and the following parameters: PVCs (r = .229, P = .015), New York Heart Association (NYHA) (r = .196, P = .033), and VT (r = .223, P = .018). Following multiple linear regression, left ventricular ejection fraction (LVEF) (P ≤ .001) and serum urea (P = .037) were predictors of PVCs among HHF patients. Serum creatinine (P ≤ .001), elevated systolic blood pressure (SBP) (P = .005), and PVCs (P ≤ .001) were important predictors of VT among HHF patients.Conclusions:Renal dysfunction and reduced LVEF were important predictors of ventricular arrhythmias. High counts of PVCs and elevated SBP were predictive of the occurrence of VT among HHF patients. The NYHA class and ventricular arrhythmias have a significant positive correlation with AF. The SDNN is reduced in HHF patients.

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Section: Discussionmentioning

confidence: 99%

Clinical and Echocardiographic Predictors of Arrhythmias Detected With 24-Hour Holter Electrocardiography Among Hypertensive Heart Failure Patients in Nigeria

Mene-Afejuku

Balogun

Akintomide

et al. 2017

Clin Med Insights Cardiol

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“…Jiménez-Candil et al [18] reported that NSVT episodes identified on ICD interrogation in patients with reduced LVEF were an independent predictor of cardiac Fig. 4 Kaplan-Meier analysis of all-cause mortality according to the presence of precedent non-sustained ventricular tachycardia.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of precedent asymptomatic non-sustained ventricular tachycardias on subsequent ICD interventions and heart failure hospitalization in primary prevention ICD patients

et al. 2020

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Background: The prognostic implications of non-sustained ventricular tachycardia (NSVT) and their significance as therapeutic targets in patients without prior sustained ventricular arrhythmias remain undetermined. The aim of this study was to investigate the prognostic significance of asymptomatic NSVT in patients who had primary prevention implantable cardioverter-defibrillator (ICD) implantation due to ischemic or non-ischemic cardiomyopathy (ICM, NICM). Methods: We enrolled 157 consecutive primary prevention ICD patients without previous appropriate ICD therapy (AIT). Patients were allocated to two groups depending on the presence or absence of NSVT in a 6-month period prior to enrollment. The incidence of AIT and unplanned hospitalization due to decompensated heart failure (HF) were assessed during follow-up. Results: In 51 patients (32%), precedent NSVT was documented. During a median follow-up of 1011 days, AIT occurred in 36 patients (23%) and unplanned HF hospitalization was observed in 32 patients (20%). In precedent NSVT patients, the incidence of AIT and unplanned HF hospitalization was significantly higher as compared to patients without precedent NSVT (AIT: 29/51 [57%] vs. 7/106 [7%], P < 0.001, log-rank; HF hospitalization: 16/51 [31%] vs. 16/106 [15%], P = 0.043, log-rank). Cox-regression demonstrated that precedent NSVT independently predicted AIT (P < 0.0001). In subgroup analyses, precedent NSVT predicted AIT in both ICM and NICM (P < 0.0001, P = 0.020), but predicted HF hospitalization only in patients with ICM (P = 0.0030). Conclusions: Precedent non-sustained VT in patients with primary prevention ICDs is associated with subsequent appropriate ICD therapies, and is an independent predictor of unplanned heart failure hospitalizations in patients with ischemic cardiomyopathy.

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“…Several groups have reported that subjects with NSVTs over a wide range of cycle length (CL), are at higher adjusted risk of appropriate therapies [ 3 , 5 , 6 ] the risk being highest in those with a greater burden, defined as more than 5 episodes in the six months following the implant [ 4 ]. However, we do not have updated information on the relationship between the CL of NSVTs and the therapies subsequently applied by ICDs.…”

Section: Introductionmentioning

confidence: 99%

“…However, we do not have updated information on the relationship between the CL of NSVTs and the therapies subsequently applied by ICDs. This sub-analysis of our previously published experience [ 4 ] aims to determine the ability of CL of NSVT episodes (identified upon ICD interrogation during the first 6 months after implant) to predict the incidence and characteristics of tachycardias that will subsequently produce appropriate therapies.…”

Section: Introductionmentioning

confidence: 99%

Cycle length of nonsustanied ventricular tachycardias among ICD patients: implications on subsequent appropriate therapies

Jiménez‐Candil

Duran

Oterino

et al. 2021

BMC Cardiovasc Disord

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Background ICD patients with episodes of nonsustained ventricular tachycardias (NSVT) are at risk of appropriate therapies. However, the relationship between the cycle length (CL) of such NSVTs and the subsequent incidence of appropriate interventions is unknown. Methods 416 ICD patients with LVEF < 45% were studied. ICD programming was standardized. NSVT was defined as any VT of 5 or more beats at ≥ 150 bpm occurred in the first 6 months after implantation that terminated spontaneously and was not preceded by any appropriate therapy. The mean follow-up was 41 ± 27 months. Results We analyzed 2201 NSVTs (mean CL = 323 ms) that occurred in 250 patients; 111 of such episodes were fast (CL ≤ 300 ms). Secondary prevention (HR = 1.7; p < 0.001), number of NSVT episodes (HR = 1.05; 95% CI 1.04–1.07; p < 0.001) and beta-blocker treatment (HR = 0.7; p = 0.04) were independent predictors of appropriate interventions; however, the mean CL of NSVTs was not (p = 0.6). There was a correlation between the mean CL of NSVTs and the CL of the first monomorphic VT: r = 0.88; p < 0.001. This correlation was especially robust in individuals with > 5 NSVTs (r = 0.97; p < 0.001), with an agreement between both values greater than 95%. Patients with any fast NSVT experienced a higher incidence of VF episodes (26%) compared to those without NVSTs (3%) or with only slow NSVTs (7%); p < 0.001. Conclusions Unlike the burden, the CL of NSVTs is not a predictor of subsequent appropriate interventions. However, there is a close relationship between the CL of NSVTs and that of arrhythmias that will later lead to appropriate therapies.

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Prognostic Significance of Nonsustained Ventricular Tachycardia Episodes Occurring Early After Implantable Cardioverter-Defibrillator Implantation Among Patients With Left Ventricular Dysfunction

Cited by 15 publications

References 20 publications

Clinical and Echocardiographic Predictors of Arrhythmias Detected With 24-Hour Holter Electrocardiography Among Hypertensive Heart Failure Patients in Nigeria

Clinical and Echocardiographic Predictors of Arrhythmias Detected With 24-Hour Holter Electrocardiography Among Hypertensive Heart Failure Patients in Nigeria

Clinical significance of precedent asymptomatic non-sustained ventricular tachycardias on subsequent ICD interventions and heart failure hospitalization in primary prevention ICD patients

Cycle length of nonsustanied ventricular tachycardias among ICD patients: implications on subsequent appropriate therapies

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