The clinical impact of untreated slow ventricular tachycardia in patients carrying implantable cardiac defibrillators
Introduction The clinical impact of slow ventricular tachycardia (VT), occurring in patients carrying implantable cardiac defibrillators (ICD), is still under debate. Methods and results From the UMBRELLA registry (multicenter, observational, and prospective study on patients with ICD), 659 episodes...
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Published in | Journal of interventional cardiac electrophysiology Vol. 62; no. 1; pp. 103 - 111 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
New York
Springer US
01.10.2021
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Summary: | Introduction
The clinical impact of slow ventricular tachycardia (VT), occurring in patients carrying implantable cardiac defibrillators (ICD), is still under debate.
Methods and results
From the UMBRELLA registry (multicenter, observational, and prospective study on patients with ICD), 659 episodes of slow VT were observed in 97 patients. Untreated slow VT (
n
= 93) had longer duration (23.7 min, CI95%: 10–39), compared with episodes treated effectively by anti-tachycardia pacing (ATP;
n
= 527; 0.32 min, IC95%: 0.22–0, 48) or shock (
n
= 39; 1 min, CI95%: 0.8–1.2). Despite of longer duration, the time to the first contact with the medical services was similar to those episodes treated by ATP (50 days [CI95%: 45–55] vs. 41 days [CI95%: 39–44]). However, both were significantly longer than the time observed in episodes treated with shock (10 days, CI95%: 6–15). This tendency was maintained with successive interrogations of the device (2nd and 3rd). There were no significant differences in mortality during follow-up (48 ± 16 months), neither other adverse outcomes, between patients who presented untreated slow TV and those who did not (log-rank
p
= 0.28). In a Cox regression analysis, the variable “presenting untreated episodes of slow VT” was not able to predict mortality. However, being in sinus rhythm (vs. atrial fibrillation, OR: 0.31,
p
= 0.009), narrower QRS (OR: 1.036,
p
= 0.037) and diabetes (OR 4.673,
p
= 0.049) appropriately predict survival.
Conclusions
Untreated slow VT does not significantly worsen patient prognosis. Our results support the limitation of therapies to ATP only, thus avoiding therapies that have been associated with increased risk of morbidity and mortality. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 |
ISSN: | 1383-875X 1572-8595 |
DOI: | 10.1007/s10840-020-00877-w |