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Predictive value of rapid-rate non-sustained ventricular tachycardia in the occurrence of appropriate implantable cardioverter-defibrillator therapy

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

Rapid-rate non-sustained ventricular tachycardia (RR-NSVT) that meets detection criteria but terminates itself before the delivery of implantable cardioverter-defibrillator (ICD) therapy is not rare in routine ICD interrogation. Whether sustained ventricular tachycardia/fibrillation will occur in a short time after RR-NSVT has not been fully elucidated.

Methods

Clinical features and follow-up data of 828 ICD patients with home monitoring were retrospectively collected. RR-NSVT characteristics and time interval between the first episode of RR-NSVT and subsequent appropriate ICD therapy were analyzed.

Results

During a mean follow-up of 44.75 ± 20.87 months, 335 episodes of RR-NSVT were documented in 145 patients. A total of 119 patients had both RR-NSVT and appropriate ICD therapy. In multivariate COX regression models, RR-NSVT was an independent predictor of appropriate ICD therapy (HR 7.599, 95%CI 5.926–9.745, P < 0.001), appropriate shock (HR 6.222, 95%CI 4.667–8.294, P < 0.001), and all-cause mortality (HR 2.156, 95%CI 1.499–3.099, P < 0.001). Appropriate ICD therapy was administered after the first RR-NSVT episode in 101 patients, with a median interval of 21 days. Compared to RR-NSVT with appropriate ICD therapy occurring beyond 21 days, RR-NSVT within 21 days prior to appropriate ICD therapy had a longer median duration time (14 s vs. 12 s, P = 0.013), but without significant difference in mean RR interval at initial detection and mean RR interval after episode termination.

Conclusions

Rapid-rate non-sustained VT was an independent predictor of appropriate ICD therapy and all-cause mortality. The presence of RR-NSVT should be considered a possible herald of more serious cardiac events in ICD patients.

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Funding

This work was supported by the National Science & Technology Pillar Program during the 12th Five-Year Plan Period (2011BAI11B02).

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Authors and Affiliations

  1. State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China

    You Zhou, Shuang Zhao, Keping Chen, Wei Hua & Shu Zhang

  2. Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China

    Yangang Su

  3. Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangzhou, China

    Silin Chen

  4. Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, China

    Zhaoguang Liang

  5. Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing, China

    Wei Xu

Authors
  1. You Zhou
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  2. Shuang Zhao
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  4. Wei Hua
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Correspondence to Shu Zhang.

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Zhou, Y., Zhao, S., Chen, K. et al. Predictive value of rapid-rate non-sustained ventricular tachycardia in the occurrence of appropriate implantable cardioverter-defibrillator therapy. J Interv Card Electrophysiol 57, 473–480 (2020). https://doi.org/10.1007/s10840-019-00557-4

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  • DOI: https://doi.org/10.1007/s10840-019-00557-4

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