Publikation

Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: results from a multicentre long-term registry

Wissenschaftlicher Artikel/Review - 01.11.2019

Bereiche
PubMed
DOI

Zitation
Auricchio A, Notarangelo F, Braun-Dullaeus R, Regoli F, Caputo M, Özkartal T, Zegard A, Martino A, Sticherling C, Conti M, Honarbakhsh S, Moccetti T, Casu G, Rinaldi C, Brugada P, Haïssaguerre M, Brugada J, Heidbuchel H, Pappone C, Curti M, Klersy C, Derval N, Haugaa K, Levinstein M, Michowitz Y, Márquez M, Stokke M, Letsas K, Calo' L, Burri H, Frontera A, Schaer B, Arbelo E, de Asmundis C, Ciconte G, Lambiase P, Belhassen B, Leyva F, Porter B, Saenen J, de Potter T, Geller J, Medeiros-Domingo A, Sarquella Brugada G, Rordorf R, Luani B, Zardini M, Ammann P, Berne P, Zacà V, Conte G. Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: results from a multicentre long-term registry. Europace 2019; 21:1670-1677.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
Europace 2019; 21
Veröffentlichungsdatum
01.11.2019
eISSN (Online)
1532-2092
Seiten
1670-1677
Kurzbeschreibung/Zielsetzung

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.