Prevalence and prognostic association of ventricular arrhythmia in non-ischaemic heart failure patients: results from the DANISH trial
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Prevalence and prognostic association of ventricular arrhythmia in non-ischaemic heart failure patients : results from the DANISH trial. / Boas, Rune; Thune, Jens Jakob; Pehrson, Steen; Køber, Lars; Nielsen, Jens C.; Videbæk, Lars; Haarbo, Jens; Korup, Eva; Bruun, Niels Eske; Brandes, Axel; Eiskjær, Hans; Thøgersen, Anna M.; Philbert, Berit T.; Svendsen, Jesper Hastrup; Dixen, Ulrik.
In: Europace, Vol. 23, No. 4, 2021, p. 587-595.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Prevalence and prognostic association of ventricular arrhythmia in non-ischaemic heart failure patients
T2 - results from the DANISH trial
AU - Boas, Rune
AU - Thune, Jens Jakob
AU - Pehrson, Steen
AU - Køber, Lars
AU - Nielsen, Jens C.
AU - Videbæk, Lars
AU - Haarbo, Jens
AU - Korup, Eva
AU - Bruun, Niels Eske
AU - Brandes, Axel
AU - Eiskjær, Hans
AU - Thøgersen, Anna M.
AU - Philbert, Berit T.
AU - Svendsen, Jesper Hastrup
AU - Dixen, Ulrik
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - Implantable cardioverter-defibrillator
KW - Non-ischaemic heart failure
KW - Non-sustained ventricular tachycardia
KW - Premature ventricular contractions
KW - Ventricular arrhythmia
U2 - 10.1093/europace/euaa341
DO - 10.1093/europace/euaa341
M3 - Journal article
C2 - 33257933
AN - SCOPUS:85104047168
VL - 23
SP - 587
EP - 595
JO - Europace
JF - Europace
SN - 1099-5129
IS - 4
ER -
ID: 260300435