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Comparison of ventricular tachyarrhythmia recurrence between ischemic cardiomyopathy and dilated cardiomyopathy: a

Chih-Yuan Fang1,2, Huang-Chung Chen1,2, Yung-Lung Chen1,2

  • 1Cardiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

Peerj
|July 25, 2018
PubMed

Insights

Dilated cardiomyopathy patients experience more ventricular tachycardia/fibrillation recurrences after ICD implantation than ischemic cardiomyopathy patients. An enlarged left ventricle predicts recurrence in ischemic cardiomyopathy, but not dilated cardiomyopathy.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • Implantable cardioverter-defibrillators (ICDs) are standard for secondary prevention of ventricular tachycardia (VT)/ventricular fibrillation (VF).
  • Clinical predictors for recurrent VT/VF differ between ischemic cardiomyopathy (ICM) and dilated cardiomyopathy (DCM), but this is under-reported.

Purpose of the Study:

  • To compare clinical predictors of recurrent VT/VF in patients with ICM versus DCM receiving ICDs for secondary prevention.
  • To analyze differences in VT/VF recurrence rates, mortality, and ventricular remodeling between ICM and DCM cohorts.

Main Methods:

  • Retrospective analysis of 132 patients (94 ICM, 38 DCM) who received ICDs for secondary prevention (May 2004-Dec 2015).
  • Validation of anti-tachycardia events, comparison of clinical and echocardiographic parameters.
  • Analysis of VT/VF recurrence, cardiovascular mortality, all-cause mortality, and changes in left ventricular ejection fraction (LVEF) and volume.

Main Results:

  • Higher VT/VF recurrence in DCM (57.9%) vs. ICM (36.2%) (p=0.032) over 3.62 years.
  • DCM patients had lower LVEF, larger LV end-diastolic volume (LVEDV), and larger LV end-systolic volume.
  • Large LVEDV (>158 mL) and lack of ACE inhibitor/ARB use predicted VT/VF recurrence in ICM, but not DCM. No mortality differences observed.

Conclusions:

  • Dilated cardiomyopathy patients exhibit a higher rate of VT/VF recurrence post-ICD implantation compared to ischemic cardiomyopathy patients.
  • Enlarged left ventricle is an independent predictor for VT/VF recurrence in ICM patients undergoing ICD therapy for secondary prevention.
Abstract

Keywords:
Dilated cardiomyopathyImplantable cardioverter-defibrillatorIschemic cardiomyopathyVentricular tachyarrhythmia

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