Prevalence and prognostic association of ventricular arrhythmia in non-ischaemic heart failure patients: results from the DANISH trial

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DOI

  • Rune Boas, Københavns Universitet
  • ,
  • Jens Jakob Thune, Københavns Universitet
  • ,
  • Steen Pehrson, Københavns Universitet
  • ,
  • Lars Køber, Københavns Universitet
  • ,
  • Jens C Nielsen
  • Lars Videbæk, Odense University Hospital
  • ,
  • Jens Haarbo, Gentofte University Hospital, Copenhagen, Denmark.
  • ,
  • Eva Korup, Aalborg Universitet
  • ,
  • Niels Eske Bruun, Københavns Universitet, Zealand University Hospital
  • ,
  • Axel Brandes, Odense University Hospital
  • ,
  • Hans Eiskjær
  • Anna M Thøgersen, Aalborg Universitet
  • ,
  • Berit T Philbert, Rigshospitalet
  • ,
  • Jesper Hastrup Svendsen, Københavns Universitet
  • ,
  • Ulrik Dixen, Københavns Universitet

AIMS: Improved risk stratification to identify non-ischaemic heart failure patients who will benefit from primary prophylactic implantable cardioverter-defibrillator (ICD) is needed. We examined the potential of ventricular arrhythmia to identify patients who could benefit from an ICD.

METHODS AND RESULTS: A total of 850 non-ischaemic systolic heart failure patients with left ventricle ≤35% and elevated N-terminal pro-brain natriuretic peptides had a 24-h Holter monitor recording performed. We examined present non-sustained ventricular tachycardia (NSVT), defined as ≥3 consecutive premature ventricular contractions (PVCs) with a rate of ≥100/min, and number of PVCs per hour stratified into low (<30) and high burden (≥30) groups. Outcome measures were overall mortality, sudden cardiac death (SCD), and cardiovascular death (CVD). In total, 193 patients died, 49 from SCD and 125 from CVD. Non-sustained ventricular tachycardia (365 patients) was significantly associated with increased all-cause mortality [hazard ratio (HR) 1.47; 95% confidence interval (CI) 1.07-2.03; P = 0.02] and to CVD (HR 1.89; CI 1.25-2.87; P = 0.003). High burden PVC (352 patients) was associated with increased all-cause mortality (HR1.38; CI 1.00-1.90; P = 0.046) and with CVD (HR 1.78; CI 1.19-2.66; P = 0.005). There was no statistically significant association with SCD for neither NSVT nor PVC. In interaction analyses, neither NSVT (P = 0.56) nor high burden of PVC (P = 0.97) was associated with survival benefit from ICD implantation.

CONCLUSION: Ventricular arrhythmia in non-ischaemic heart failure patients was associated with a worse prognosis but could not be used to stratify patients to ICD implantation.

OriginalsprogEngelsk
TidsskriftEuropace
Vol/bind23
Nummer4
Sider (fra-til)587–595
Antal sider9
ISSN1099-5129
DOI
StatusUdgivet - apr. 2021

Bibliografisk note

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.

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