Prognostic significance of non-sustained ventricular tachycardia on stored electrograms in pacemaker recipients

• Published in: PloS one 2019-11, Vol.14 (11), p.e0225059-e0225059
• Main Authors: Bencardino, Gianluigi, Spera, Francesco Raffaele, Pinnacchio, Gaetano, Perna, Francesco, Narducci, Maria Lucia, Comerci, Gianluca, Pelargonio, Gemma, Gabrielli, Francesca Augusta, La Rosa, Giulio, Lanza, Gaetano Antonio, Crea, Filippo
• Format: Article
• Language: English
• Subjects: Aged; Analysis; Arrhythmia; Biology and Life Sciences; Cardiac arrhythmia; Cardiovascular disease; Clinical medicine; Coronary artery; Coronary artery disease; Coronary heart disease; Coronary vessels; Electrocardiography; Engineering and Technology; Family medical history; Female; Follow-Up Studies; Heart; Heart attack; Heart attacks; Heart block; Heart diseases; Humans; Hypertension; Implantation; Male; Medical prognosis; Medicine and Health Sciences; Mortality; Multivariate Analysis; Myocardial infarction; Pacemaker, Artificial; Patients; Prognosis; Proportional Hazards Models; Questioning; Statistical analysis; Survival Analysis; Tachycardia; Tachycardia, Ventricular - diagnosis; Tachycardia, Ventricular - diagnostic imaging; Ventricle; Ventricular tachycardia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0225059

Little is known about the prognostic significance of non-sustained ventricular tachycardia (NS-VT) in outpatients scheduled for routine pacemaker controls. We therefore sought to investigate the prognostic significance of non-sustained ventricular tachycardia on stored electrograms in pacemaker recipients. We enrolled patients implanted with dual chamber pacemaker for atrioventricular block or sinus node dysfunction from 2010 to 2016, with LVEF> 45%, older than 18 years, with at least 3 device interrogations at follow-up. Data were collected about medical history, pharmacological therapy at implantation, pacemaker programming, NS-VT occurrence, long-term survival. A total of 308 patients were included in the final analysis, with median follow-up time of 56 months. No ventricular arrhythmic episodes were documented in 221 patients (Group 1), whereas 87 had at least 1 episode of NS-VT during follow-up (Group 2). As a whole, 282 episodes of NS-VT were documented. There was a higher prevalence of previous myocardial infarction and slightly lower left ventricular ejection fraction (LVEF) in Group 2. The primary endpoint (all-cause mortality) occurred in 50 patients (22%) of Group 1 and 12 (14%) patients of Group 2 (p = 0.07). Clinical predictors of all-cause mortality at univariate analysis included age, LVEF and coronary artery disease (CAD). Only age and CAD, however, remained as predictors of mortality at multivariable analysis. A sizeable, but not statistically significant, portion of patients who died had a de novo occurrence of NS-VT at the last pacemaker check. Our data do not support a prognostic role for the detection of NS-VT during pacemaker controls.