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The Association of Clustered Ventricular Arrhythmia and Cycle Length With Scar Burden in Cardiomyopathy

Rachit M Vakil1, Joseph E Marine1, Aravindan Kolandaivelu1

  • 1Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.

JACC. Clinical Electrophysiology
|August 18, 2022
PubMed

Insights

Patients with clustered ventricular arrhythmias (VA) face higher mortality risks. Scar characteristics in nonischemic cardiomyopathy (NICM) significantly predict clustered VA and its cycle length, with larger scars indicating greater risk.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Electrophysiology

Background:

  • Clustered ventricular arrhythmias (VA) in patients with cardiomyopathy increase mortality risk.
  • Understanding risk factors for clustered VA is crucial for patient management.

Purpose of the Study:

  • To investigate the association between scar characteristics on cardiovascular magnetic resonance imaging (CMR) and clustered VA.
  • To examine the relationship between scar characteristics and VA cycle length in nonischemic cardiomyopathy (NICM) and ischemic cardiomyopathy (ICM).

Main Methods:

  • Analysis of data from 329 primary prevention implantable cardioverter-defibrillator (ICD) recipients.
  • Assessment of scar characteristics using CMR in patients with NICM and ICM.
  • Correlation of scar burden and type with clustered VA incidence and VA cycle length.

Main Results:

  • Clustered VA occurred in 21 patients, with men at higher risk.
  • NICM patients with scar showed the highest incidence of clustered VA.
  • In NICM, increased core scar correlated with higher clustered VA risk and longer VA cycle length.
  • Higher body mass index correlated with shorter VA cycle length in ICM patients.

Conclusions:

  • Clustered VA is most prevalent in NICM patients with scar, particularly those with larger core scar burdens.
  • Core scar characteristics influence VA cycle length in NICM, while BMI affects it in ICM.
  • No specific scar pattern predominated in relation to clustered VA, and VA type was similar across etiologies.
Abstract

Keywords:
cardiovascular magnetic resonancerisk stratificationsudden cardiac deathventricular arrhythmia

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