Nonsustained ventricular tachycardia in heart failure with preserved ejection fraction

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Abstract

Background: Ventricular tachycardia (VT) is a common arrhythmia in heart failure with reduced ejection fraction but its incidence, predictors, and significance have not been determined in heart failure with preserved ejection fraction (HFpEF). Methods: We performed a retrospective review of arrhythmias in two cohorts of patients with an HFpEF diagnosis. Patients in cohort 1 (n = 40) underwent routine arrhythmia surveillance with a 14-day ambulatory electrocardiogram (ECG) monitor. Patients in cohort 2 (n = 85) had cardiac pacemakers and underwent routine device interrogations. Results: In cohort 1, 13 patients (32.5%) had one or more episodes of nonsustained VT (NSVT) on ambulatory ECG. In cohort 2, 38 patients (44.7%) had NSVT on cardiac pacemaker interrogations. During a median (interquartile range) follow-up of 3.0 (1.6 to 5.1) years, 15 (12%) patients died (20% of patients with NSVT versus 6.8% of those without NSVT; P =.03). In logistic regression analysis, NSVT was associated with a 3.4-fold higher odds of death (95% confidence interval 1.08 to 10.53; P =.04) in HFpEF. Conclusions: In conclusion, patients with HFpEF have a relatively high, and possibly underappreciated, burden of NSVT, which confers a higher risk of mortality. The frequent episodes of NSVT in these patients may provide insight into the mechanism of sudden cardiac death in HFpEF.

Original languageEnglish (US)
Pages (from-to)1126-1131
Number of pages6
JournalPACE - Pacing and Clinical Electrophysiology
Volume43
Issue number10
DOIs
StatePublished - Oct 1 2020

Bibliographical note

Funding Information:
Dr Adabag has received research grants from the American Heart Association and Medtronic. The other authors report no financial relationships or conflict of interest regarding the content herein as well as no other relevant relationships to industry.

Publisher Copyright:
© 2020 Wiley Periodicals LLC

Keywords

  • congestive heart failure
  • electrophysiology–clinical
  • ventricular tachycardia

PubMed: MeSH publication types

  • Journal Article

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