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.

Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: Results from a multicentre long-term registry / 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.; Zaca, V.; Berne, P.; Ammann, P.; Zardini, M.; Luani, B.; Rordorf, R.; Sarquella Brugada, G.; Medeiros-Domingo, A.; Geller, J. -C.; De Potter, T.; Stokke, M. K.; Marquez, M. F.; Michowitz, Y.; Honarbakhsh, S.; Conti, M.; Sticherling, C.; Martino, A.; Zegard, A.; Ozkartal, T.; Caputo, M. L.; Regoli, F.; Braun-Dullaeus, R. C.; Notarangelo, F.; Moccetti, T.; Casu, G.; Rinaldi, C. A.; Levinstein, M.; Haugaa, K. H.; Derval, N.; Klersy, C.; Curti, M.; Pappone, C.; Heidbuchel, H.; Brugada, J.; Haissaguerre, M.; Brugada, P.; Auricchio, A.. - In: EUROPACE. - ISSN 1099-5129. - 21:11(2019), pp. 1670-1677. [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 G.;Casu G.;
2019-01-01

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.
2019
Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: Results from a multicentre long-term registry / 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.; Zaca, V.; Berne, P.; Ammann, P.; Zardini, M.; Luani, B.; Rordorf, R.; Sarquella Brugada, G.; Medeiros-Domingo, A.; Geller, J. -C.; De Potter, T.; Stokke, M. K.; Marquez, M. F.; Michowitz, Y.; Honarbakhsh, S.; Conti, M.; Sticherling, C.; Martino, A.; Zegard, A.; Ozkartal, T.; Caputo, M. L.; Regoli, F.; Braun-Dullaeus, R. C.; Notarangelo, F.; Moccetti, T.; Casu, G.; Rinaldi, C. A.; Levinstein, M.; Haugaa, K. H.; Derval, N.; Klersy, C.; Curti, M.; Pappone, C.; Heidbuchel, H.; Brugada, J.; Haissaguerre, M.; Brugada, P.; Auricchio, A.. - In: EUROPACE. - ISSN 1099-5129. - 21:11(2019), pp. 1670-1677. [10.1093/europace/euz221]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11388/323801
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