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Prognostic significance of non-sustained ventricular tachycardia on stored electrograms in pacemaker recipients


Autoři: Gianluigi Bencardino aff001;  Francesco Raffaele Spera aff001;  Gaetano Pinnacchio aff001;  Francesco Perna aff001;  Maria Lucia Narducci aff001;  Gianluca Comerci aff001;  Gemma Pelargonio aff001;  Francesca Augusta Gabrielli aff001;  Giulio La Rosa aff001;  Gaetano Antonio Lanza aff001;  Filippo Crea aff001
Působiště autorů: Dipartimento di Scienze Cardiovascolari e Toraciche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy aff001;  Università Cattolica del Sacro Cuore, Roma, Italy aff002
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0225059

Souhrn

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.

Klíčová slova:

Arrhythmia – Cardiac pacing – Coronary heart disease – Ejection fraction – Medical devices and equipment – Medical implants – Pacemakers – Tachycardia


Zdroje

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