Nonsustained ventricular tachycardia in heart failure with preserved ejection fraction. Issue 10 (3rd September 2020)

• Record Type: Journal Article
• Authors: Gutierrez, Alejandra; Ash, Jerry; Akdemir, Baris; Alexy, Tamas; Cogswell, Rebecca; Chen, Jane; Adabag, Selcuk
• Is Part Of: Pacing and clinical electrophysiology. Volume 43:Issue 10(2020)
• Page Start: 1126
• Page End: 1131
• Publication Date: 2020-09-03
• Subjects: congestive heart failure -- electrophysiology–clinical -- ventricular tachycardia; Cardiac pacing -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1111/pace.14043
• Languages: English
• ISSNs: 0147-8389

Abstract

Abstract: Background: Ventricular tachycardia (VT) is a common arrhythmia in heart failure with reduced ejection fraction but its incidence, predictors, and significance have not been determined in heart failure with preserved ejection fraction (HFpEF). Methods: We performed a retrospective review of arrhythmias in two cohorts of patients with an HFpEF diagnosis. Patients in cohort 1 (n = 40) underwent routine arrhythmia surveillance with a 14‐day ambulatory electrocardiogram (ECG) monitor. Patients in cohort 2 (n = 85) had cardiac pacemakers and underwent routine device interrogations. Results: In cohort 1, 13 patients (32.5%) had one or more episodes of nonsustained VT (NSVT) on ambulatory ECG. In cohort 2, 38 patients (44.7%) had NSVT on cardiac pacemaker interrogations. During a median (interquartile range) follow‐up of 3.0 (1.6 to 5.1) years, 15 (12%) patients died (20% of patients with NSVT versus 6.8% of those without NSVT; P = .03). In logistic regression analysis, NSVT was associated with a 3.4‐fold higher odds of death (95% confidence interval 1.08 to 10.53; P = .04) in HFpEF. Conclusions: In conclusion, patients with HFpEF have a relatively high, and possibly underappreciated, burden of NSVT, which confers a higher risk of mortality. The frequent episodes of NSVT in these patients may provide insight into the mechanism of sudden cardiac death in HFpEF.