TY - JOUR
T1 - Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms
T2 - results from a multicentre long-term registry
AU - Conte, Giulio
AU - Belhassen, Bernard
AU - Lambiase, Pier
AU - Ciconte, Giuseppe
AU - de Asmundis, Carlo
AU - Arbelo, Elena
AU - Schaer, Beat
AU - Frontera, Antonio
AU - Burri, Haran
AU - Calo', Leonardo
AU - Letsas, Kostantinos P.
AU - Leyva, Francisco
AU - Porter, Bradley
AU - Saenen, Johan
AU - Zacà, Valerio
AU - Berne, Paola
AU - Ammann, Peter
AU - Zardini, Marco
AU - Luani, Blerim
AU - Rordorf, Roberto
AU - Sarquella Brugada, Georgia
AU - Medeiros-Domingo, Argelia
AU - Geller, Johann Christoph
AU - de Potter, Tom
AU - Stokke, Mathis K.
AU - Márquez, Manlio F.
AU - Michowitz, Yoav
AU - Honarbakhsh, Shohreh
AU - Conti, Manuel
AU - Sticherling, Christian
AU - Martino, Annamaria
AU - Zegard, Abbasin
AU - Özkartal, Tardu
AU - Caputo, Maria Luce
AU - Regoli, François
AU - Braun-Dullaeus, Rüdiger C.
AU - Notarangelo, Francesca
AU - Moccetti, Tiziano
AU - Casu, Gavino
AU - Rinaldi, Christopher A.
AU - Levinstein, Moises
AU - Haugaa, Kristina H.
AU - Derval, Nicolas
AU - Klersy, Catherine
AU - Curti, Moreno
AU - Pappone, Carlo
AU - Heidbuchel, Hein
AU - Brugada, Josép
AU - Haïssaguerre, Michel
AU - Brugada, Pedro
AU - Auricchio, Angelo
N1 - © 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
PY - 2019/11/1
Y1 - 2019/11/1
N2 - 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.
AB - 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.
KW - Electrocardiography
KW - Idiopathic ventricular fibrillation
KW - Implantable cardioverter-defibrillator
KW - Out-of-hospital cardiac arrest
KW - Quinidine
KW - Sudden cardiac death
UR - http://www.scopus.com/inward/record.url?scp=85074445616&partnerID=8YFLogxK
UR - https://academic.oup.com/europace/article/21/11/1670/5554426
U2 - 10.1093/europace/euz221
DO - 10.1093/europace/euz221
M3 - Article
C2 - 31504477
AN - SCOPUS:85074445616
SN - 1099-5129
VL - 21
SP - 1670
EP - 1677
JO - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
JF - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
IS - 11
ER -