Open AccessPrognostic significance of nonsustained ventricular tachycardia in patients receiving cardiac resynchronization therapy for primary prevention: Analysis of the Japan cardiac device treatment registry database
Author(s) -
Yokoshiki Hisashi,
Shimizu Akihiko,
Mitsuhashi Takeshi,
Furushima Hiroshi,
Sekiguchi Yukio,
Manaka Tetsuyuki,
Nishii Nobuhiro,
Ueyama Takeshi,
Morita Norishige,
Okamura Hideo,
Nitta Takashi,
Hirao Kenzo,
Okumura Ken
Publication year - 2018
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1002/joa3.12023
Subject(s) - medicine , ejection fraction , cardiology , heart failure , ventricular tachycardia , cardiac resynchronization therapy , implantable cardioverter defibrillator
Background Whether nonsustained ventricular tachycardia ( NSVT ) is a marker of increased risk of sustained ventricular tachyarrhythmias ( VTA s) remains to be established in patients receiving cardiac resynchronization therapy with a defibrillator ( CRT ‐D) for primary prevention. Methods Among the follow‐up data of the Japan cardiac device treatment registry ( JCDTR ) with an implantation date between January 2011 and August 2015, information regarding a history of NSVT before the CRT ‐D implantation for primary prevention had been registered in 269 patients. Outcomes were compared between two groups with and without NSVT : NSVT group (n = 179) and No NSVT group (n = 90). Results There was no significant difference with regard to age, gender, and NYHA class between the two groups. Left ventricular ejection fraction ( LVEF ) was 25.6% in the NSVT group and 28.0% in the No NSVT group ( P = .046). The rate of appropriate therapy at 24 months was 26.0% and 18.4% in the NSVT and No NSVT groups ( P = .22), respectively. Survival free from heart failure death was reduced in the NSVT group, as compared with the No NSVT group, with the rate of 90.2% vs 97.2% at 24 months ( P = .030). A multivariate analysis identified a history of NSVT , anemia, and no use of angiotensin‐converting enzyme inhibitor ( ACEI ) or angiotensin‐receptor blocker ( ARB ) as predictors of heart failure death. Conclusions NSVT appears to be a surrogate marker of severe heart failure rather than a substrate for subsequent sustained VTA s in patients with CRT ‐D for primary prevention.