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Clinical characteristics of patients with dilated cardiomyopathy and bradyarrhythmias
S Ando1, S Koyanagi, K Muramatsu
1Research Institute of Angiocardiology and Cardiovascular Clinic, Faculty of Medicine, Kyushu University, Fukuoka.
Insights
Bradyarrhythmias are common in dilated cardiomyopathy, particularly in older patients. These heart rhythm issues are linked to a higher risk of cardiac death and often require pacemakers.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Dilated cardiomyopathy (DCM) is a significant cause of heart failure.
- Bradyarrhythmias, including sinus bradycardia and atrioventricular block, can complicate DCM.
- The prevalence and impact of bradyarrhythmias in DCM patients require further investigation.
Purpose of the Study:
- To investigate the clinical characteristics of patients with dilated cardiomyopathy and bradyarrhythmias.
- To compare the outcomes of DCM patients with and without bradyarrhythmias.
- To assess the association between age and the occurrence of conduction disturbances in DCM.
Main Methods:
- Retrospective analysis of clinical data from 50 patients with dilated cardiomyopathy.
- Categorization of patients based on the presence or absence of bradyarrhythmias.
- Comparison of demographic data, cardiac parameters, and mortality rates between groups.
Main Results:
- Six out of 50 DCM patients had bradyarrhythmias, including sinus bradycardia, sick sinus syndrome (SSS), and atrioventricular block.
- Patients with bradyarrhythmias were significantly older at symptom onset (60.3 years) compared to those without (40.0 years).
- Mortality due to cardiac causes was higher in patients with bradyarrhythmias (60.0%) compared to those without (25.8%), with 4 of 5 patients requiring pacemakers.
Conclusions:
- Bradyarrhythmias are not uncommon in dilated cardiomyopathy and are associated with increased cardiac mortality.
- Elderly patients with DCM have a higher risk of developing conduction disturbances and bradyarrhythmias.
- Early identification and management of bradyarrhythmias in DCM patients are crucial for improving outcomes.
Abstract:
The clinical characteristics of patients with dilated cardiomyopathy and bradyarrhythmias were studied. Among 50 patients with dilated cardiomyopathy, 6 had bradyarrhythmias. Among these patients were one with sinus bradycardia, one with atrial fibrillation and slow ventricular responses and sick sinus syndrome (SSS), one with SSS with advanced AV block, and 3 with advanced AV block. The average age at the onset of their cardiac symptoms (60.3 +/- 12.1 years (mean +/- SD)) was significantly (p less than 0.01) higher than that of 43 patients without bradyarrhythmias (40.0 +/- 17.6). The left ventricular diastolic dimension and ejection fraction were similar among patients with and without bradyarrhythmias. In 31 follow-up patients without bradyarrhythmias, 8 (25.8%) died of cardiac causes; whereas, in 5 patients with bradyarrhythmias, 4 had been implanted with pacemakers and 3 (60.0%) died of cardiac causes. Furthermore, the age at the onset of cardiac symptoms in patients with any kind of conduction disturbance, except tachyarrhythmia, was 50.4 +/- 16.5 years (n = 25), which was significantly higher (p less than 0.02) than that of patients without conduction disturbances (37.7 +/- 19.3 years, n = 23). We concluded that bradyarrhythmias are not rare complications in patients with dilated cardiomyopathy, and the mortality rate tends to be higher in patients with bradyarrhythmias than in those without them. Furthermore, the risks of conduction disturbances and bradyarrhythmias were higher in the elderly patients.