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High risk of ventricular arrhythmias in patients with nonischemic dilated cardiomyopathy presenting with syncope

Robert S Phang1, David Kang, Hocine Tighiouart

  • 1Tufts-New England Medical Center, Boston, Massachusetts, USA. rphang@gmail.com

The American Journal of Cardiology
|January 31, 2006
PubMed

Insights

Syncope in nonischemic dilated cardiomyopathy (NIDC) indicates high risk, similar to sustained arrhythmias. Patients with NIDC and syncope may benefit from implantable cardioverter-defibrillator (ICD) therapy.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure

Background:

  • Syncope in nonischemic dilated cardiomyopathy (NIDC) prognostic significance is unclear.
  • Randomized controlled implantable cardioverter-defibrillator (ICD) trials often exclude NIDC patients.

Purpose of the Study:

  • Compare outcomes in NIDC patients with syncope versus those with sustained ventricular arrhythmias.
  • Evaluate risk factors for arrhythmias and mortality in NIDC patients.

Main Methods:

  • Retrospective comparison of 108 NIDC patients with syncope and 71 NIDC patients with sustained ventricular arrhythmias.
  • Assessed freedom from ventricular arrhythmias, life-threatening arrhythmias, and all-cause mortality.
  • Follow-up duration: 43.5 ± 32.1 months.

Main Results:

  • No significant difference in outcomes between syncope and arrhythmia groups.
  • Male gender and ICD therapy predicted increased ventricular arrhythmia risk.
  • Reduced ejection fraction and older age predicted increased mortality.

Conclusions:

  • NIDC patients presenting with syncope represent a high-risk population.
  • Event rates in syncope patients are comparable to those with sustained arrhythmias.
  • Consideration for ICD therapy is warranted in NIDC patients with syncope.

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