Prognostic significance of nonsustained ventricular tachycardia in patients receiving cardiac resynchronization therapy for primary prevention

Analysis of the Japan cardiac device treatment registry database

Members of the Implantable Cardioverter-Defibrillator (ICD) Committee of the Japanese Heart Rhythm Society

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Whether nonsustained ventricular tachycardia (NSVT) is a marker of increased risk of sustained ventricular tachyarrhythmias (VTAs) 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 VTAs in patients with CRT-D for primary prevention.

Original languageEnglish
Pages (from-to)139-147
Number of pages9
JournalJournal of Arrhythmia
Volume34
Issue number2
DOIs
Publication statusPublished - Apr 1 2018

Fingerprint

Cardiac Resynchronization Therapy
Primary Prevention
Ventricular Tachycardia
Registries
Japan
Databases
Equipment and Supplies
Defibrillators
Therapeutics
Heart Failure
Tachycardia
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Stroke Volume
Anemia

Keywords

  • Appropriate therapy
  • Cardiac resynchronization therapy with a defibrillator
  • Heart failure death
  • Nonsustained ventricular tachycardia
  • Primary prevention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prognostic significance of nonsustained ventricular tachycardia in patients receiving cardiac resynchronization therapy for primary prevention : Analysis of the Japan cardiac device treatment registry database. / Members of the Implantable Cardioverter-Defibrillator (ICD) Committee of the Japanese Heart Rhythm Society.

In: Journal of Arrhythmia, Vol. 34, No. 2, 01.04.2018, p. 139-147.

Research output: Contribution to journalArticle

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title = "Prognostic significance of nonsustained ventricular tachycardia in patients receiving cardiac resynchronization therapy for primary prevention: Analysis of the Japan cardiac device treatment registry database",
abstract = "Background: Whether nonsustained ventricular tachycardia (NSVT) is a marker of increased risk of sustained ventricular tachyarrhythmias (VTAs) 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 VTAs in patients with CRT-D for primary prevention.",
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author = "{Members of the Implantable Cardioverter-Defibrillator (ICD) Committee of the Japanese Heart Rhythm Society} and Hisashi Yokoshiki and Akihiko Shimizu and Takeshi Mitsuhashi and Hiroshi Furushima and Yukio Sekiguchi and Tetsuyuki Manaka and Nobuhiro Nishii and Takeshi Ueyama and Norishige Morita and Hideo Okamura and Takashi Nitta and Kenzo Hirao and Ken Okumura",
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AU - Yokoshiki, Hisashi

AU - Shimizu, Akihiko

AU - Mitsuhashi, Takeshi

AU - Furushima, Hiroshi

AU - Sekiguchi, Yukio

AU - Manaka, Tetsuyuki

AU - Nishii, Nobuhiro

AU - Ueyama, Takeshi

AU - Morita, Norishige

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