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Title
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Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms : results from a multicentre long-term registry
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Author
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Abstract
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| 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. |
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Language
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English
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Source (journal)
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Europace. - Oxford
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Publication
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Oxford
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2019
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ISSN
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1099-5129
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DOI
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10.1093/EUROPACE/EUZ221
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Volume/pages
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21
:11
(2019)
, p. 1670-1677
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ISI
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000498026800011
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Pubmed ID
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31504477
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Full text (Publisher's DOI)
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Full text (open access)
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