Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: results from a multicentre long-term registry. Issue 11 (25th August 2019)

• Record Type: Journal Article
• Authors: Conte, Giulio; Belhassen, Bernard; Lambiase, Pier; Ciconte, Giuseppe; de Asmundis, Carlo; Arbelo, Elena; Schaer, Beat; Frontera, Antonio; Burri, Haran; Calo', Leonardo; Letsas, Kostantinos P; Leyva, Francisco; Porter, Bradley; Saenen, Johan; Zacà, Valerio; Berne, Paola; Ammann, Peter; Zardini, Marco; Luani, Blerim; Rordorf, Roberto; Sarquella Brugada, Georgia; Medeiros-Domingo, Argelia; Geller, Johann-Christoph; de Potter, Tom; Stokke, Mathis K; Márquez, Manlio F; Michowitz, Yoav; Honarbakhsh, Shohreh; Conti, Manuel; Sticherling, Christian; Martino, Annamaria; Zegard, Abbasin; Özkartal, Tardu; Caputo, Maria Luce; Regoli, François; Braun-Dullaeus, Rüdiger C; Notarangelo, Francesca; Moccetti, Tiziano; Casu, Gavino; Rinaldi, Christopher A; Levinstein, Moises; Haugaa, Kristina H; Derval, Nicolas; Klersy, Catherine; Curti, Moreno; Pappone, Carlo; Heidbuchel, Hein; Brugada, Josép; Haïssaguerre, Michel; Brugada, Pedro; Auricchio, Angelo;
• Is Part Of: Europace. Volume 21:Issue 11(2019)
• Page Start: 1670
• Page End: 1677
• Publication Date: 2019-08-25
• Subjects: Idiopathic ventricular fibrillation -- Out-of-hospital cardiac arrest -- Sudden cardiac death -- Implantable cardioverter-defibrillator -- Quinidine -- Electrocardiography; Arrhythmia -- Treatment -- Periodicals; Cardiac pacing -- Periodicals; Catheter ablation -- Periodicals; Heart -- Physiology -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1093/europace/euz221
• Languages: English
• ISSNs: 1099-5129

Abstract

Abstract: 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.