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

Giulio Conte; Bernard Belhassen; Pier Lambiase; Giuseppe Ciconte; Carlo de Asmundis; Elena Arbelo; Beat Schaer; Antonio Frontera; Haran Burri; Leonardo Calo'; Kostantinos P. Letsas; Francisco Leyva; Bradley Porter; Johan Saenen; Valerio Zacà; Paola Berne; Peter Ammann; Marco Zardini; Blerim Luani; Roberto Rordorf; Georgia Sarquella Brugada; Argelia Medeiros-Domingo; Johann Christoph Geller; Tom de Potter; Mathis K. Stokke; Manlio F. Márquez; Yoav Michowitz; Shohreh Honarbakhsh; Manuel Conti; Christian Sticherling; Annamaria Martino; Abbasin Zegard; Tardu Özkartal; Maria Luce Caputo; François Regoli; Rüdiger C. Braun-Dullaeus; Francesca Notarangelo; Tiziano Moccetti; Gavino Casu; Christopher A. Rinaldi; Moises Levinstein; Kristina H. Haugaa; Nicolas Derval; Catherine Klersy; Moreno Curti; Carlo Pappone; Hein Heidbuchel; Josép Brugada; Michel Haïssaguerre; Pedro Brugada; Angelo Auricchio

doi:10.1093/europace/euz221

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

Giulio Conte
, Bernard Belhassen
, Pier Lambiase
, Giuseppe Ciconte
, Carlo de Asmundis
, Elena Arbelo
, Beat Schaer
, Antonio Frontera
, Haran Burri
, Leonardo Calo'
, Kostantinos P. Letsas
, Francisco Leyva
, Bradley Porter
, Johan Saenen
, Valerio Zacà
, Paola Berne
, Peter Ammann
, Marco Zardini
, Blerim Luani
, Roberto Rordorf

Georgia Sarquella Brugada, Argelia Medeiros-Domingo, Johann Christoph Geller, Tom de Potter, Mathis K. Stokke, Manlio F. Márquez, Yoav Michowitz, Shohreh Honarbakhsh, Manuel Conti, Christian Sticherling, Annamaria Martino, Abbasin Zegard, Tardu Özkartal, Maria Luce Caputo, François Regoli, Rüdiger C. Braun-Dullaeus, Francesca Notarangelo, Tiziano Moccetti, Gavino Casu, Christopher A. Rinaldi, Moises Levinstein, Kristina H. Haugaa, Nicolas Derval, Catherine Klersy, Moreno Curti, Carlo Pappone, Hein Heidbuchel, Josép Brugada, Michel Haïssaguerre, Pedro Brugada, Angelo Auricchio

Fondazione Cardiocentro Ticino
Tel Aviv University School of Medicine
Barts Health NHS Trust
Arrhythmia and Electrophysiology Center IRCCS
Universitair Ziekenhuis Brussel
Hospital Clinic Barcelona
Bordeaux University Hospital
University Hospital Geneva
Division of Cardiology
Evangelismos General Hospital of Athens
Aston University
Guy's and St Thomas NHS Foundation Trust
University Hospital Antwerp
AOU Senese
Ospedale San Francesco
Kardiologie
Azienda Ospedaliero-Universitaria di Parma
Magdeburg University
Fondazione IRCCS Policlinico San Matteo
Universitat Autònoma de Barcelona
University of Girona
Bern University Hospital
Cardiology Department
OLV Hospital
Oslo University Hospital Rikshospitalet
National Institute of Cardiology Ignacio Chavez
American British Cowdray Medical Center

Research output: Contribution to journal › Article › peer-review

51 Citations (Scopus)

74 Downloads (Pure)

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.

Original language	English
Pages (from-to)	1670-1677
Number of pages	8
Journal	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
Volume	21
Issue number	11
Early online date	25 Aug 2019
DOIs	https://doi.org/10.1093/europace/euz221
Publication status	Published - 1 Nov 2019

Bibliographical note

© 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 [email protected]

Keywords

Electrocardiography
Idiopathic ventricular fibrillation
Implantable cardioverter-defibrillator
Out-of-hospital cardiac arrest
Quinidine
Sudden cardiac death

Access to Document

10.1093/europace/euz221

Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation
© 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 [email protected]
Final published version, 371 KBLicence: CC BY-NC 3.0

Cite this

Conte, G., Belhassen, B., Lambiase, P., Ciconte, G., de Asmundis, C., Arbelo, E., Schaer, B., Frontera, A., Burri, H., Calo', L., Letsas, K. P., Leyva, F., Porter, B., Saenen, J., Zacà, V., Berne, P., Ammann, P., Zardini, M., Luani, B., ... Auricchio, A. (2019). Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: results from a multicentre long-term registry. 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, 21(11), 1670-1677. https://doi.org/10.1093/europace/euz221

Conte, Giulio ; Belhassen, Bernard ; Lambiase, Pier et al. / Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms : results from a multicentre long-term registry. In: 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. 2019 ; Vol. 21, No. 11. pp. 1670-1677.

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title = "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.",

keywords = "Electrocardiography, Idiopathic ventricular fibrillation, Implantable cardioverter-defibrillator, Out-of-hospital cardiac arrest, Quinidine, Sudden cardiac death",

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note = "{\textcopyright} 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 [email protected]",

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Conte, G, Belhassen, B, Lambiase, P, Ciconte, G, de Asmundis, C, Arbelo, E, Schaer, B, Frontera, A, Burri, H, Calo', L, Letsas, KP, Leyva, F, Porter, B, Saenen, J, Zacà, V, Berne, P, Ammann, P, Zardini, M, Luani, B, Rordorf, R, Sarquella Brugada, G, Medeiros-Domingo, A, Geller, JC, de Potter, T, Stokke, MK, Márquez, MF, Michowitz, Y, Honarbakhsh, S, Conti, M, Sticherling, C, Martino, A, Zegard, A, Özkartal, T, Caputo, ML, Regoli, F, Braun-Dullaeus, RC, Notarangelo, F, Moccetti, T, Casu, G, Rinaldi, CA, Levinstein, M, Haugaa, KH, Derval, N, Klersy, C, Curti, M, Pappone, C, Heidbuchel, H, Brugada, J, Haïssaguerre, M, Brugada, P & Auricchio, A 2019, 'Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: results from a multicentre long-term registry', 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, vol. 21, no. 11, pp. 1670-1677. https://doi.org/10.1093/europace/euz221

Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: results from a multicentre long-term registry. / Conte, Giulio; Belhassen, Bernard; Lambiase, Pier et al.
In: 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, Vol. 21, No. 11, 01.11.2019, p. 1670-1677.

Research output: Contribution to journal › Article › peer-review

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 [email protected]

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 - https://www.scopus.com/pages/publications/85074445616

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 -

Conte G, Belhassen B, Lambiase P, Ciconte G, de Asmundis C, Arbelo E et al. Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: results from a multicentre long-term registry. 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. 2019 Nov 1;21(11):1670-1677. Epub 2019 Aug 25. doi: 10.1093/europace/euz221