Prognostic Significance of Non-sustained Ventricular Tachycardia on Stored Electrograms in Pacemaker Recipients

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2019 Nov 16

PMID 31730671

Citations 1

Authors

Gianluigi Bencardino

Francesco Raffaele Spera

Gaetano Pinnacchio

Francesco Perna

Maria Lucia Narducci

Gianluca Comerci

Gemma Pelargonio

Francesca Augusta Gabrielli

Giulio La Rosa

Gaetano Antonio Lanza

Filippo Crea

Affiliations

Soon will be listed here.

Abstract

Background: Little is known about the prognostic significance of non-sustained ventricular tachycardia (NS-VT) in outpatients scheduled for routine pacemaker controls. We therefore sought to investigate the prognostic significance of non-sustained ventricular tachycardia on stored electrograms in pacemaker recipients.

Methods: We enrolled patients implanted with dual chamber pacemaker for atrioventricular block or sinus node dysfunction from 2010 to 2016, with LVEF> 45%, older than 18 years, with at least 3 device interrogations at follow-up. Data were collected about medical history, pharmacological therapy at implantation, pacemaker programming, NS-VT occurrence, long-term survival.

Results: A total of 308 patients were included in the final analysis, with median follow-up time of 56 months. No ventricular arrhythmic episodes were documented in 221 patients (Group 1), whereas 87 had at least 1 episode of NS-VT during follow-up (Group 2). As a whole, 282 episodes of NS-VT were documented. There was a higher prevalence of previous myocardial infarction and slightly lower left ventricular ejection fraction (LVEF) in Group 2. The primary endpoint (all-cause mortality) occurred in 50 patients (22%) of Group 1 and 12 (14%) patients of Group 2 (p = 0.07). Clinical predictors of all-cause mortality at univariate analysis included age, LVEF and coronary artery disease (CAD). Only age and CAD, however, remained as predictors of mortality at multivariable analysis. A sizeable, but not statistically significant, portion of patients who died had a de novo occurrence of NS-VT at the last pacemaker check.

Conclusion: Our data do not support a prognostic role for the detection of NS-VT during pacemaker controls.

Citing Articles

Novel Approach to Risk Stratification in Left Ventricular Non-Compaction Using A Combined Cardiac Imaging and Plasma Biomarker Approach.

Ramchand J, Podugu P, Obuchowski N, Harb S, Chetrit M, Milinovich A J Am Heart Assoc. 2021; 10(8):e019209.

PMID: 33834849 PMC: 8174181. DOI: 10.1161/JAHA.120.019209.

References

Jamil H, Mohammed S, Gierula J, Paton M, Lowry J, Cubbon R . Prognostic Significance of Incidental Nonsustained Ventricular Tachycardia Detected on Pacemaker Interrogation. Am J Cardiol. 2018; 123(3):409-413. DOI: 10.1016/j.amjcard.2018.10.040. View

Engstrom G, Hedblad B, Janzon L, Juul-Moller S . Ventricular arrhythmias during 24-h ambulatory ECG recording: incidence, risk factors and prognosis in men with and without a history of cardiovascular disease. J Intern Med. 1999; 246(4):363-72. DOI: 10.1046/j.1365-2796.1999.00509.x. View

Zoghbi W, Enriquez-Sarano M, Foster E, Grayburn P, Kraft C, Levine R . Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr. 2003; 16(7):777-802. DOI: 10.1016/S0894-7317(03)00335-3. View

Zhou X, Gunderson B, Olson W . Incidence of nonsustained and sustained ventricular tachyarrhythmias in patients with an implantable cardioverter defibrillator. J Cardiovasc Electrophysiol. 2004; 15(1):14-20. DOI: 10.1046/j.1540-8167.2004.03154.x. View

Baumgartner H, Hung J, Bermejo J, Chambers J, Evangelista A, Griffin B . Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. J Am Soc Echocardiogr. 2009; 22(1):1-23. DOI: 10.1016/j.echo.2008.11.029. View

Senges J, Becker R, Schreiner K, Bauer A, Weretka S, Siegler K . Variability of Holter electrocardiographic findings in patients fulfilling the noninvasive MADIT criteria. Multicenter Automatic Defibrillator Implantation Trial. Pacing Clin Electrophysiol. 2002; 25(2):183-90. DOI: 10.1046/j.1460-9592.2002.00183.x. View

Seth N, Kaplan R, Bustamante E, Kulkarni C, Subacius H, Rosenthal J . Clinical Significance of Nonsustained Ventricular Tachycardia on Routine Monitoring of Pacemaker Patients. Pacing Clin Electrophysiol. 2015; 38(8):980-8. DOI: 10.1111/pace.12632. View

Mammarella A, Paradiso M, Basili S, De Matteis A, Cardarello C, Di Franco M . Morphologic left ventricular patterns and prevalence of high-grade ventricular arrhythmias in the normotensive and hypertensive elderly. Adv Ther. 2001; 17(5):222-9. DOI: 10.1007/BF02853161. View

Mittal S, Lomnitz D, Mirchandani S, Stein K, Markowitz S, Slotwiner D . Prognostic significance of nonsustained ventricular tachycardia after revascularization. J Cardiovasc Electrophysiol. 2002; 13(4):342-6. DOI: 10.1046/j.1540-8167.2002.00342.x. View

10.

Cheema A, Sheu K, Parker M, KADISH A, Goldberger J . Nonsustained ventricular tachycardia in the setting of acute myocardial infarction: tachycardia characteristics and their prognostic implications. Circulation. 1998; 98(19):2030-6. DOI: 10.1161/01.cir.98.19.2030. View

11.

Buxton A, Fisher J, Josephson M, Lee K, Pryor D, Prystowsky E . Prevention of sudden death in patients with coronary artery disease: the Multicenter Unsustained Tachycardia Trial (MUSTT). Prog Cardiovasc Dis. 1993; 36(3):215-26. DOI: 10.1016/0033-0620(93)90015-6. View

12.

Lin C, Chang S, Chung F, Chen Y, Lin Y, Lo L . Long-Term Outcome of Non-Sustained Ventricular Tachycardia in Structurally Normal Hearts. PLoS One. 2016; 11(8):e0160181. PMC: 4993359. DOI: 10.1371/journal.pone.0160181. View

13.

Larsson B, Elmqvist H, Ryden L, Schuller H . Lessons from the first patient with an implanted pacemaker: 1958-2001. Pacing Clin Electrophysiol. 2003; 26(1 Pt 1):114-24. DOI: 10.1046/j.1460-9592.2003.00162.x. View

14.

Gabriels J, Wu M, Rosen L, Patel A, Goldner B . Clinical Significance of Nonsustained Ventricular Tachycardia on Stored Electrograms in Permanent Pacemaker Patients. Pacing Clin Electrophysiol. 2016; 39(12):1335-1339. DOI: 10.1111/pace.12968. View

15.

Katritsis D, Camm A . Nonsustained ventricular tachycardia: where do we stand?. Eur Heart J. 2004; 25(13):1093-9. DOI: 10.1016/j.ehj.2004.03.022. View

16.

Moss A, Zareba W, Hall W, Klein H, Wilber D, Cannom D . Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002; 346(12):877-83. DOI: 10.1056/NEJMoa013474. View