Non-Sustained Ventricular Tachycardia Episodes Predict Future Hospitalization in ICD Recipients with Heart Failure

Abstract

BackgroundImplantable cardioverter-defibrillator (ICD) therapy is well known to reduce mortality in selected patients with heart failure (HF).ObjectiveTo investigate whether monitored episodes of non-sustained ventricular tachycardia (NSVT) might predict future HF hospitalizations in ICD recipients with HF.MethodsWe examined 104 ICD recipients (mean age: 60 ± 10.1 years, 80.8 % male) with HF who were referred to our outpatient clinic for device follow-up. After device interrogation, patients were divided into NSVT positive and negative groups. The primary endpoint was the rate of hospitalization within the next 6 months after initial ICD evaluation.ResultsDevice evaluation demonstrated at least one episode of monitored NSVT in 50 out of 104 patients. As expected, no device therapy (shock or anti-tachycardia) was needed for such episodes. At 6 months, 24 patients were hospitalized due to acute decompensated HF. Hospitalization rate was significantly lower in the NSVT negative as compared with positive groups (38% versus 62%; adjusted hazard ratio [HR] 0.166 ; 95% CI 0.056 to 0.492; p = 0.01).ConclusionsMonitored NSVT bouts in ICD recordings may serve as a predictor of future HF hospitalizations in ICD recipients with HF suggesting optimization of therapeutic modalities in these patients along with a close supervision in the clinical setting.

Prior history of atrial fibrillation and arrhythmic outcomes: Data from the WEARIT‐II prospective registry

“…For example, a study retrospectively evaluating 104 ICD recipients showed that monitored bouts of NSVT in ICD recordings may serve as a predictor of heart failure hospitalizations in such patients. 14 In one study, among ICD patients with left ventricular dysfunction, NSVT episodes occurring in the first 6 months after implant were independently associated with poor outcomes including an increased risk of appropriate shocks. 15 The mechanism by which NSVT is associated with adverse outcomes is thought to be related to sympathetic hyperactivation.…”

“…In addition to its association with SCD, NSVT is also associated with adverse clinical outcomes. For example, a study retrospectively evaluating 104 ICD recipients showed that monitored bouts of NSVT in ICD recordings may serve as a predictor of heart failure hospitalizations in such patients 14 . In one study, among ICD patients with left ventricular dysfunction, NSVT episodes occurring in the first 6 months after implant were independently associated with poor outcomes including an increased risk of appropriate shocks 15 .…”

Pacemaker follow-up after device replacement

“…Pacemaker technology has made great progress in recent years and pacemaker follow-up visits provide more information on heart rate histograms, heart rate variability, supraventricular or ventricular arrhythmia episodes, and patient activity etc. These data are very important for assessment of the patient's clinical status [4].…”

Prognostic Significance of Non-Sustained Ventricular Tachycardia Depends on Its Rate and Duration

“…We read the article “Non-Sustained Ventricular Tachycardia (NSVT) Episodes Predict Future Hospitalization in ICD Recipients with Heart Failure” written by Uçar et al. 1 with great interest. NSVT identified on routine ICD interrogation should be considered an important clinical event as the authors state in this article.…”

“…We thank the journal readers for their great interest in our original article titled “Non-Sustained Ventricular Tachycardia Episodes Predict Future Hospitalization in ICD Recipients with Heart Failure” recently published in Arquivos Brasileiros de Cardiologia. 1 …”