Non-sustained ventricular tachycardia in patients with congenital heart disease: An important sign?

详细信息    查看全文

• 作者：Christophe P. Teuwen^a ; ¹ ; Tanwier T.T.K. Ramdjan^a ; ¹ ; Marco Gö ; tte^b ; Bianca J.J.M. Brundel^c ; Reinder Evertz^d ; Joris W.J. Vriend^b ; Sander G. Molhoek^e ; H.G. Reinhart Dorman^f ; Jurren M. van Opstal^f ; Thelma C. Konings^g ; Pepijn van der Voort^h ; Etienne Delacretazⁱ ; Nienke J. Wolfhagen^a ; Virgilla van Gastel^a ; Peter de Klerk^a ; Dominic A. Theuns^a ; Maarten Witsenburg^a ; Jolien W. Roos-Hesselink^a ; John K. Triedman^j ; Ad J.J.C. Bogers^k ; Natasja M.S. de Groot^a ; ^{n.m.s.degroot@erasmusmc.nl" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Congenital heart defects ; Ventricular tachyarrhythmia ; Implantable cardioverter defibrillator
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：1 March 2016
• 年：2016
• 卷：206
• 期：Complete
• 页码：158-163
• 全文大小：798 K

文摘

Sustained ventricular tachycardia (susVT) and ventricular fibrillation (VF) are observed in adult patients with congenital heart disease (CHD). These dysrhythmias may be preceded by non-sustained ventricular tachycardia (NSVT). The aims of this study are to examine the 1] time course of ventricular tachyarrhythmia (VTA) in a large cohort of patients with various CHDs and 2] the development of susVT/VF after NSVT.

Methods

In this retrospective study, patients with VTA on ECG, 24-hour Holter or ICD-printout or an out-of-hospital-cardiac arrest due to VF were included. In patients with an ICD, the number of shocks was studied.

Results

Patients (N = 145 patients, 59% male) initially presented with NSVT (N = 103), susVT (N = 25) or VF (N = 17) at a mean age of 40 ± 14 years. Prior to VTA, 58 patients had intraventricular conduction delay, 14 an impaired ventricular dysfunction and 3 had coronary artery disease. susVT/VF rarely occurred in patients with NSVT (N = 5). Fifty-two (36%) patients received an ICD; appropriate and inappropriate shocks, mainly due to supraventricular tachycardia (SVT), occurred in respectively 15 (29%) (NSVT: N = 1, susVT: N = 9, VF: N = 5) and 12 (23%) (NSVT: N = 4, susVT: N = 5, VF: N = 3) patients.

Conclusions

VTA in patients with CHD appear on average at the age of 40 years. susVT/VF rarely developed in patients with only NSVT, whereas recurrent episodes of susVT/VF frequently developed in patients initially presenting with susVT/VF. Hence, a wait-and-see treatment strategy in patients with NSVT and aggressive therapy of both episodes of VTA and SVT in patients with susVT/VF seems justified.