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

Publication

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

Journal Paper/Review - Nov 1, 2019

Auricchio Angelo, Notarangelo Francesca, Braun-Dullaeus Rüdiger C, Regoli François, Caputo Maria Luce, Özkartal Tardu, Zegard Abbasin, Martino Annamaria, Sticherling Christian, Conti Manuel, Honarbakhsh Shohreh, Moccetti Tiziano, Casu Gavino, Rinaldi Christopher A, Brugada Pedro, Haïssaguerre Michel, Brugada Josép, Heidbuchel Hein, Pappone Carlo, Curti Moreno, Klersy Catherine, Derval Nicolas, Haugaa Kristina H, Levinstein Moises, Michowitz Yoav, Márquez Manlio F, Stokke Mathis K, Letsas Kostantinos P, Calo' Leonardo, Burri Haran, Frontera Antonio, Schaer Beat, Arbelo Elena, de Asmundis Carlo, Ciconte Giuseppe, Lambiase Pier, Belhassen Bernard, Leyva Francisco, Porter Bradley, Saenen Johan, de Potter Tom, Geller Johann-Christoph, Medeiros-Domingo Argelia, Sarquella Brugada Georgia, Rordorf Roberto, Luani Blerim, Zardini Marco, Ammann Peter, Berne Paola, Zacà Valerio, Conte Giulio

Citation

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.

Type

Journal Paper/Review (English)

Journal

Europace 2019; 21

Publication Date

Nov 1, 2019

Issn Electronic

1532-2092

Pages

1670-1677

Brief description/objective

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.