Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: results from a multicentre long-term registry
Por:
Conte G, Belhassen B, Lambiase P, Ciconte G, de Asmundis C, Arbelo E, Schaer B, Frontera A, Burri H, Calo' L, Letsas KP, Leyva F, Porter B, Saenen J, Zacà V, Berne P, Ammann P, Zardini M, Luani B, Rordorf R, Sarquella-Brugada G, Medeiros-Domingo A, Geller JC, de Potter T, Stokke MK, Márquez MF, Michowitz Y, Honarbakhsh S, Conti M, Sticherling C, Martino A, Zegard A, Özkartal T, Caputo ML, Regoli F, Braun-Dullaeus RC, Notarangelo F, Moccetti T, Casu G, Rinaldi CA, Levinstein M, Haugaa KH, Derval N, Klersy C, Curti M, Pappone C, Heidbuchel H, Brugada-Terradellas J, Haïssaguerre M, Brugada P and Auricchio A
Publicada:
1 nov 2019
Ahead of Print:
25 ago 2019
Resumen:
Aims To define the clinical characteristics and long-term clinical outcomes of a large cohort of patients with idiopathic ventricular fibrillation (IVF) and normal 12-lead electrocardiograms (ECGs).
Methods and results Patients with ventricular fibrillation as the presenting rhythm, normal baseline, and follow-up ECGs with no signs of cardiac channelopathy including early repolarization or atrioventricular conduction abnormalities, and without structural heart disease were included in a registry. A total of 245 patients (median age: 38 years; males 59%) were recruited from 25 centres. An implantable cardioverter-defibrillator (ICD) was implanted in 226 patients (92%), while 18 patients (8%) were treated with drug therapy only. Over a median follow-up of 63 months (interquartile range: 25-110 months), 12 patients died (5%); in four of them (1.6%) the lethal event was of cardiac origin. Patients treated with antiarrhythmic drugs only had a higher rate of cardiovascular death compared to patients who received an ICD (16% vs. 0.4%, P=0.001). Fifty-two patients (21%) experienced an arrhythmic recurrence. Age <= 16 years at the time of the first ventricular arrhythmia was the only predictor of arrhythmic recurrence on multivariable analysis [hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.18-0.92; P=0.03].
Conclusion Patients with IVF and persistently normal ECGs frequently have arrhythmic recurrences, but a good prognosis when treated with an ICD. Children are a category of IVF patients at higher risk of arrhythmic recurrences.
Filiaciones:
Conte G:
Electrophysiology Unit, Department of Cardiology, Fondazione Cardiocentro Ticino, via Tesserete 48, 6900 Lugano, Switzerland
Belhassen B:
Department of Cardiology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Lambiase P:
Electrophysiology Department, Barts Heart Centre, Barts Health NHS trust, London, UK
Ciconte G:
Cardiology Department, Arrhythmia and Electrophysiology Center IRCCS, Policlinico San Donato, Italy
de Asmundis C:
Cardiovascular Department, Heart Rhythm Management Centre, UZ-VUB, Jette, Brussels
Arbelo E:
Cardiology Department, Arrhythmias Unit, Hospital Clinic, Barcelona, Spain
Schaer B:
Kardiologie/Elektrophysiologie Universitätsspital, Basel, Switzerland
Frontera A:
LIRYC Institute, INSERM 1045, Bordeaux University Hospital, Bordeaux, France
Burri H:
Cardiology Department, University Hospital of Geneva, Switzerland
Calo' L:
Division of Cardiology, Policlinico Casilino, Roma, Italy
Letsas KP:
Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, Athens, Greece
Leyva F:
Aston Medical Research Institute, Aston University, Birmingham, UK
Porter B:
Guy's and St Thomas' Hospital, London, UK
Saenen J:
University Hospital Antwerp, Antwerp, Belgium
Zacà V:
Arrhythmology Unit, Cardiovascular and Thoracic Department, AOU Senese, Siena, Italy
Berne P:
Cardiology Department, Ospedale San Francesco, Nuoro, Italy
Ammann P:
Kardiologie, Kantonsspital St. Gallen, St. Gallen, Switzerland
Zardini M:
Cardiology Department, Parma University Hospital, Parma, Italy
Luani B:
Division of Cardiology and Angiology, Department of Internal Medicine, Magdeburg University, Magdeburg, Germany
Rordorf R:
Elettrofisiologia ed Elettrostimolazione, Divisione di Cardiologia, IRCCS Policlinico S. Matteo, Pavia, Italy
Sarquella-Brugada G:
Arrhythmia and Inherited Cardiac Diseases Unit, Hospital Sant Joan de Déu, University of Barcelona, Spain
Medical Sciences Department, Medical School, University of Girona, Girona, Spain
Medeiros-Domingo A:
Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
Geller JC:
Cardiology Department, Rhythmologie und invasive Elektrophysiologie, Zentralklinik Bad Berka, Bad Berka, Germany
de Potter T:
Electrophysiology Section, Department of Cardiology, OLV Hospital, Aalst, Belgium
Stokke MK:
Center for Cardiological Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Norway
Márquez MF:
Electrocardiology Department, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
Michowitz Y:
Department of Cardiology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Honarbakhsh S:
Electrophysiology Department, Barts Heart Centre, Barts Health NHS trust, London, UK
Conti M:
Cardiology Department, Arrhythmia and Electrophysiology Center IRCCS, Policlinico San Donato, Italy
Sticherling C:
Kardiologie/Elektrophysiologie Universitätsspital, Basel, Switzerland
Martino A:
Division of Cardiology, Policlinico Casilino, Roma, Italy
Zegard A:
Aston Medical Research Institute, Aston University, Birmingham, UK
Özkartal T:
Electrophysiology Unit, Department of Cardiology, Fondazione Cardiocentro Ticino, via Tesserete 48, 6900 Lugano, Switzerland
Caputo ML:
Electrophysiology Unit, Department of Cardiology, Fondazione Cardiocentro Ticino, via Tesserete 48, 6900 Lugano, Switzerland
Regoli F:
Electrophysiology Unit, Department of Cardiology, Fondazione Cardiocentro Ticino, via Tesserete 48, 6900 Lugano, Switzerland
Braun-Dullaeus RC:
Division of Cardiology and Angiology, Department of Internal Medicine, Magdeburg University, Magdeburg, Germany
Notarangelo F:
Cardiology Department, Parma University Hospital, Parma, Italy
Moccetti T:
Electrophysiology Unit, Department of Cardiology, Fondazione Cardiocentro Ticino, via Tesserete 48, 6900 Lugano, Switzerland
Casu G:
Cardiology Department, Ospedale San Francesco, Nuoro, Italy
Rinaldi CA:
Guy's and St Thomas' Hospital, London, UK
Levinstein M:
Cardiology Department, Cardiovascular Center, American British Cowdray Medical Center, Mexico City, Mexico
Haugaa KH:
Center for Cardiological Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Norway
Derval N:
LIRYC Institute, INSERM 1045, Bordeaux University Hospital, Bordeaux, France
Klersy C:
Service of Biometry and Clinical Epidemiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
Curti M:
Service of Biometry and Clinical Epidemiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
Pappone C:
Cardiology Department, Arrhythmia and Electrophysiology Center IRCCS, Policlinico San Donato, Italy
Heidbuchel H:
University Hospital Antwerp, Antwerp, Belgium
Brugada-Terradellas J:
Cardiology Department, Arrhythmias Unit, Hospital Clinic, Barcelona, Spain
Haïssaguerre M:
LIRYC Institute, INSERM 1045, Bordeaux University Hospital, Bordeaux, France
Brugada P:
Cardiovascular Department, Heart Rhythm Management Centre, UZ-VUB, Jette, Brussels
Auricchio A:
Electrophysiology Unit, Department of Cardiology, Fondazione Cardiocentro Ticino, via Tesserete 48, 6900 Lugano, Switzerland
Green Submitted, Green Published, Bronze
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