Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms:results from a multicentre long-term registry

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.

Publication DOI: https://doi.org/10.1093/europace/euz221
Divisions: College of Health & Life Sciences > Aston Medical School > Translational Medicine Research Group (TMRG)
College of Health & Life Sciences > Aston Medical School
Additional Information: © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
Uncontrolled Keywords: Electrocardiography,Idiopathic ventricular fibrillation,Implantable cardioverter-defibrillator,Out-of-hospital cardiac arrest,Quinidine,Sudden cardiac death,Cardiology and Cardiovascular Medicine,Physiology (medical)
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Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
https://academi ... 11/1670/5554426 (Publisher URL)
PURE Output Type: Article
Published Date: 2019-11-01
Published Online Date: 2019-08-25
Accepted Date: 2019-07-18
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

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