Journal article
Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: results from a multicentre long-term registry.
- Conte G Electrophysiology Unit, Department of Cardiology, Fondazione Cardiocentro Ticino, via Tesserete 48, 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.
- 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, Lugano, Switzerland.
- Caputo ML Electrophysiology Unit, Department of Cardiology, Fondazione Cardiocentro Ticino, via Tesserete 48, Lugano, Switzerland.
- Regoli F Electrophysiology Unit, Department of Cardiology, Fondazione Cardiocentro Ticino, via Tesserete 48, 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, 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 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, Lugano, Switzerland.
- 2019-09-11
Published in:
- Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. - 2019
Electrocardiography
Idiopathic ventricular fibrillation
Implantable cardioverter-defibrillator
Out-of-hospital cardiac arrest
Quinidine
Sudden cardiac death
Adolescent
Adult
Child
Defibrillators, Implantable
Electrocardiography
Female
Follow-Up Studies
Humans
Male
Middle Aged
Out-of-Hospital Cardiac Arrest
Reference Values
Registries
Retrospective Studies
Time Factors
Ventricular Fibrillation
Young Adult
English
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.
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.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1093/europace/euz221
- PMID 31504477
- Persistent URL
- https://sonar.ch/global/documents/6130
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