Prognostic significance of nonsustained ventricular tachycardia in patients receiving cardiac resynchronization therapy for primary prevention: Analysis of the Japan cardiac device treatment registry database

Journal of Arrhythmia

Members of the Implantable Cardioverter‐Defibrillator (ICD) Committee of the Japanese Heart Rhythm Society¹  Tetsuyuki Manaka²  Ken Okumura³  Yukio Sekiguchi⁴  Takeshi Mitsuhashi⁵  Hisashi Yokoshiki⁶  Hideo Okamura⁷  Nobuhiro Nishii⁸  Takashi Nitta⁹  Norishige Morita^1,10  Takeshi Ueyama^1,11  Akihiko Shimizu^1,12  Hiroshi Furushima^1,13  Kenzo Hirao^1,14 

[1] ;Asakusa Heart Clinic Tokyo Japan;Cardiovascular Center Saiseikai Kumamoto Hospital Kumamoto Japan;Cardiovascular Division Faculty of Medicine University of Tsukuba Tsukuba Japan;Cardiovascular Medicine Jichi Medical University Saitama Medical Center Saitama Japan;Department of Cardiovascular Medicine Hokkaido University Graduate School of Medicine Sapporo Japan;Department of Cardiovascular Medicine National Hospital Organization Wakayama Hospital Hidakagun Japan;Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan;Department of Cardiovascular Surgery Nippon Medical School Tokyo Japan;Division of Cardiology Department of Medicine Tokai University Hachioji Hospital Hachioji Japan;Division of Cardiology Department of Medicine and Clinical Sciences Yamaguchi Graduate School of Medicine Ube Japan;Faculty of Health Sciences Yamaguchi Graduate School of Medicine Ube Japan;Furushima Clinic Niigata Japan;Heart Rhythm Center Tokyo Medical and Dental University Tokyo Japan;

关键词: appropriate therapy;    cardiac resynchronization therapy with a defibrillator;    heart failure death;    nonsustained ventricular tachycardia;    primary prevention;   

DOI  :  10.1002/joa3.12023

来源: DOAJ

【 摘 要 】

Abstract Background Whether nonsustained ventricular tachycardia (NSVT) is a marker of increased risk of sustained ventricular tachyarrhythmias (VTAs) remains to be established in patients receiving cardiac resynchronization therapy with a defibrillator (CRT‐D) for primary prevention. Methods Among the follow‐up data of the Japan cardiac device treatment registry (JCDTR) with an implantation date between January 2011 and August 2015, information regarding a history of NSVT before the CRT‐D implantation for primary prevention had been registered in 269 patients. Outcomes were compared between two groups with and without NSVT: NSVT group (n = 179) and No NSVT group (n = 90). Results There was no significant difference with regard to age, gender, and NYHA class between the two groups. Left ventricular ejection fraction (LVEF) was 25.6% in the NSVT group and 28.0% in the No NSVT group (P = .046). The rate of appropriate therapy at 24 months was 26.0% and 18.4% in the NSVT and No NSVT groups (P = .22), respectively. Survival free from heart failure death was reduced in the NSVT group, as compared with the No NSVT group, with the rate of 90.2% vs 97.2% at 24 months (P = .030). A multivariate analysis identified a history of NSVT, anemia, and no use of angiotensin‐converting enzyme inhibitor (ACEI) or angiotensin‐receptor blocker (ARB) as predictors of heart failure death. Conclusions NSVT appears to be a surrogate marker of severe heart failure rather than a substrate for subsequent sustained VTAs in patients with CRT‐D for primary prevention.

【 授权许可】

Unknown