Electrophysiological study as a predictor of mortality in unexplained syncope
Javier Pinos1,2,3, Gustavo Glotz De Lima1,4, Roberto Sant'Anna1
1Cardiology Institute of Rio Grande Do Sul University Foundation of Cardiology Porto Alegre Brazil.
Insights
Electrophysiological study findings significantly impact syncope patient survival. Specific findings like split His and sustained ventricular tachycardia predict mortality, alongside age and heart failure.
Area of Science:
- Cardiology
- Electrophysiology
- Clinical Research
Background:
- Electrophysiological study (EPS) aids in diagnosing syncope.
- Prognostic implications of EPS findings in syncope patients require further investigation.
Purpose of the Study:
- To evaluate syncope patient survival based on EPS findings.
- To identify independent clinical and electrophysiological predictors of all-cause mortality.
Main Methods:
- Retrospective cohort study of 383 syncope patients undergoing EPS (2009-2018).
- Cox logistic regression analysis to determine prognostic factors for mortality.
Main Results:
- The split His group exhibited the poorest survival, followed by sustained ventricular tachycardia and HV interval ≥ 70 ms.
- Age, congestive heart failure, split His, and sustained ventricular tachycardia were identified as independent predictors of all-cause mortality.
Conclusions:
- Patients with split His, sustained ventricular tachycardia, or HV interval ≥ 70 ms showed reduced survival.
- Key mortality predictors include age, congestive heart failure, split His, and sustained ventricular tachycardia.
Background:
Electrophysiological study can help in the diagnosis of arrhythmic syncope. According to the electrophysiological study finding, the prognosis of patients with syncope is still a matter of study.
Objective:
The aim of this study was to assess the survival of patients undergoing electrophysiological study according to their findings and to identify clinical and electrophysiological independent predictors of all-cause mortality.
Methods:
A retrospective cohort study included patients with syncope who underwent electrophysiological study from 2009 to 2018. A Cox logistic regression analysis was performed to identify independent prognostic factors for all-cause mortality.
Results:
We included 383 patients in our study. During a mean follow-up of 59 months, 84 (21.9%) patients died. The split His group had the worst survival compared with the control group, followed by sustained ventricular tachycardia and HV interval ≥ 70 ms, respectively (p = .001; p < .001; p = .03). The supraventricular tachycardia group showed no differences compared with the control group (p = .87). In the multivariate analysis, independent predictors of all-cause mortality were Age (OR 1.06; 1.03-1.07; p < .001); congestive heart failure (OR 1.82; 1.05-3.15; p = .033); split His (OR 3.7; 1.27-10.80; p = .016); and sustained ventricular tachycardia (OR 1.84; 1.02-3.32; p = .04).
Conclusion:
Split His, sustained ventricular tachycardia, and HV interval ≥ 70 ms groups had worse survivals when compared to the control group. Age, congestive heart failure, split His, and sustained ventricular tachycardia were independent predictors for all-cause mortality.
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