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Cardiac defibrillator implantation in patients with syncope and inducible ventricular arrhythmia: insights from the German Device Registry

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Bibliographic Details
Published in: Scientific reports year:2023; elocationid:12182; 13(2023), Artikel-ID 12182, Seite 1-10; pages:1-10; extent:10; volume:13
Authors and Corporations: Kahle, Ann-Kathrin (Author), Senges, Jochen (Author), Hochadel, Matthias (Author), Brachmann, Johannes (Author), Thomas, Dierk (Author), Straube, Florian (Author), Bonaventura, Klaus (Author), Larbig, Robert (Author), Werner, Nikos (Author), Butter, Christian (Author), Alken, Fares-Alexander (Author), Meyer, Christian (Author)
Other Authors: Senges, Jochen 1942- [Author] • Hochadel, Matthias [Author] • Brachmann, Johannes [Author] • Thomas, Dierk 1974- [Author] • Straube, Florian 1979- [Author] • Bonaventura, Klaus 1967- [Author] • Larbig, Robert [Author] • Werner, Nikos [Author] • Butter, Christian [Author] • Alken, Fares-Alexander [Author] • Meyer, Christian [Author]
Type of Resource: E-Book Component Part
Language: English
published:
2023
Series: Scientific reports, 13(2023), Artikel-ID 12182, Seite 1-10
Subjects:
Source: Verbunddaten SWB
Lizenzfreie Online-Ressourcen
ISSN: 2045-2322
Description
Summary: History of syncope is an independent predictor for sudden cardiac death. Programmed stimulation may be considered for risk stratification, but data remain sparse among different populations. Here, we analyzed the prognostic value of inducible ventricular arrhythmia (VA) regarding clinical outcome in patients with syncope undergoing defibrillator implantation. Among 4196 patients enrolled in the prospective, multi-center German Device Registry, patients with syncope and inducible VA (n = 285, 6.8%) vs. those with a secondary preventive indication (n = 1885, 45.2%), defined as previously documented sustained ventricular tachycardia or ventricular fibrillation, serving as a control group were studied regarding demographics, device implantation and post-procedural adverse events. Patients with syncope and inducible VA (64.9 ± 14.4 years, 81.1% male) presented less frequently with congestive heart failure (15.1% vs. 29.1%; p < 0.001) and any structural heart disease (84.9% vs. 89.3%; p = 0.030) than patients with a secondary preventive indication (65.0 ± 13.8 years, 81.0% male). Whereas dilated cardiomyopathy (16.8% vs. 23.8%; p = 0.009) was less common, hypertrophic cardiomyopathy (5.6% vs. 2.8%; p = 0.010) and Brugada syndrome (2.1% vs. 0.3%; p < 0.001) were present more often. During 1-year-follow-up, mortality (5.1% vs. 8.9%; p = 0.036) and the rate of major adverse cardiac or cerebrovascular events (5.8% vs. 10.0%; p = 0.027) were lower in patients with syncope and inducible VA. Among patients with inducible VA, post-procedural adverse events including rehospitalization (27.6% vs. 21.7%; p = 0.37) did not differ between those with vs. without syncope. Taken together, patients with syncope and inducible VA have better clinical outcomes than patients with a secondary preventive defibrillator indication, but comparable outcomes to patients without syncope, which underlines the relevance of VA inducibility, potentially irrespective of a syncope.
Item Description: Veröffentlicht: 27. Juli 2023
Gesehen am 10.10.2023
Physical Description: Illustrationen
10
ISSN: 2045-2322
DOI: 10.1038/s41598-023-37440-2