Incidence of Idiopathic Ventricular Arrhythmias

Abstract

Background Ventricular tachycardia (VT) and premature ventricular complexes (PVC) most frequently occur in the context of structural heart disease. However, the burden of idiopathic ventricular arrhythmias (VA) in the general population is unknown. Methods and Results We identified incident cases of idiopathic VA between 2005and 2013 from Olmsted County, MN using the Rochester Epidemiology Project database. For PVC cohorts, we included those with frequent (defined as ≥100 PVC/24 hours) symptomatic PVCs. We defined idiopathic VA-associated cardiomyopathy as an EF drop of ≥10% from baseline. Between 2005 and 2013, we identified 614 individuals with incident idiopathic VA. (229 [37.3%] were male, average age was 52.1 ± 17.2 years). Of these, 177 (28.8%) had idiopathic VT, 408 (66.5%) had symptomatic PVCs and 29 (4.7%) had idiopathic VA-associated cardiomyopathy. The age- and sex- adjusted incidence rates in 2005–2007, 2008–2010 and 2011–2013 were 44.9 per 100,000 (95% CI 38.0–51.8), 47.6 per 100,000 (95% CI 40.8–54.5) and 62.0 per 100,000 (95% CI 54.4–69.6), respectively. In idiopathic VT, there was an increase in incidence rate with age s (P<0.001) but not between sexes (P=0.12). The age-adjusted incidence of symptomatic PVC was higher in females than males (46.2 per 100,000 [95% CI 40.9–51.6] versus 20.5 per 100,000 [95% CI 16.8–24.3], p<0.001). The small number of individuals with idiopathic VA-associated cardiomyopathy precluded any formal testing. Conclusions The incidence of idiopathic VA is increasing. Furthermore, overall incidence increases with age. While the rate of idiopathic VT is similar across genders, women have a higher incidence of symptomatic PVC.

Premature Ventricular Complex-induced Cardiomyopathy

“…A large study by Latchamsetty et al suggested that male sex may be an independent risk factor for the development of cardiomyopathy. 37,38 Surksha et al found that the incidence of symptomatic PVCs was greater in women, while that of idiopathic ventricular tachycardia was similar among sexes. 39 Considering that asymptomatic status could delay the diagnosis and hence facilitate the development of a cardiomyopathy, women may be less prone to develop cardiomyopathy as they will be treated at an earlier stage.…”

Recent trends in cardiac electrophysiology and catheter ablation in New Zealand

“…23 With the rise in incidence of idiopathic ventricular arrhythmias, improved survival of patients with heart failure and those with recurrent VT storms or implantable cardioverter defibrillator (ICD) treatments, as well as improved survival in those with coronary artery disease and valvular heart disease, VT ablation rates are likely to continue to rise in the near future. 26,27 There was marked difference in the growth of EP procedure rates in the public and private sector. While the EP procedure rates in the public sector stagnated, the procedure rates in the private sector have doubled.…”

“…However, the growth of VT ablations in Australia was 12–18% per year compared to approximately 10% per year in NZ 23 . With the rise in incidence of idiopathic ventricular arrhythmias, improved survival of patients with heart failure and those with recurrent VT storms or implantable cardioverter defibrillator (ICD) treatments, as well as improved survival in those with coronary artery disease and valvular heart disease, VT ablation rates are likely to continue to rise in the near future 26–27 …”

Ten‐year trends in catheter ablation for ventricular tachycardia vs other interventional procedures in Australia

“…Despite significant improvements in the management of predisposing conditions, especially coronary artery disease (CAD), the incidence of VT has increased when comparing older RCTs where the recurrence rate was 33% to contemporary RCTs which has a recurrence rate between 42%‐45% . In those with idiopathic VT, a recent population‐based study found rates had increased from 12.7 to 16.2 (per 100 000) over a 6‐year period . Paralleling increasing rates of VT is recent local data showing a three‐fold increased rate of ICD implantation over a similar period that incurs significant additional costs on the healthcare system.…”

“…7,8 In those with idiopathic VT, a recent population-based study found rates had increased from 12.7 to 16.2 (per 100 000) over a 6-year period. 22 Paralleling increasing rates of VT is recent local data showing a three-fold increased rate of ICD implantation over a similar period 3 that incurs significant additional costs on the healthcare system. Certainly, additional strategies are required to reduce rates and healthcare expenditure, of which CA has emerged as a useful adjunctive therapy.…”