12.7 Plasma levels of pufa and ventricular arrhythmias in icd patients with ischemic cardiomyopathy

F. Zoppo, E. Bertaglia, G. Roselli della Rovere, F. Zerbo, D. D'Este, E. Manzato, P. Pascotto
2003 Europace  
the identification of pts with idiopathic dilated cardiomyopathy (DC) at high risk of sudden death (SD) is still an unsolved issue and the role of arrhythmias uncertain. Aim of the study: to evaluate the role of non-sustained ventricular tachycardia (nsVT) in predicting the risk of total and SD in pts with DCM enrolled in a large single-center registry. Methods and results: the population consisted of 554 pts with DC prospectively followed in the Heart Muscle Disease Registry of Trieste. At
more » ... t evaluation, mean age was 45±15 years old, NYHA functional class was 2±0.9, left ventricular ejection fraction (EF) was 0.31±0.1, left ventricular enddiastolic diameter (LVEDD) 6.7±1 cm; the interval since the first symptom was 35±54 months. At the moment of the diagnosis 240 pts (43%) had nsVT at 24-48 Holter monitoring. Both in the VT and in the non VT groups 20% of pts were treated with amiodarone; in the VT group 57% were treated with betablockers at the higher dosage tolerated, vs 53% in the no VT group (p NS). During follow-up (81±58 months) 188 pts (34%) died or underwent heart transplantation;75 pts (13.5%) died suddenly. Pts with and without VT had the same survival rate (free from heart transplant) at 2 years (89% vs 88%, p NS), 5 years (76% vs 76%; p NS) and 10 years (61% vs 60%) (p NS). Also the incidence of SD was similar in the VT and th e no VT group at 2 years (3% vs 3%), 5 years (10% vs 7%) and 10 years (22% vs 18%) (p NS). Finally, the survival rate and the SD rate were similar in more severly impaired pts (with both EF 0,30 and LVEDD 7 cm) with VT (54%, SD 26%) and without VT (51%, SD 19%) but worse than in pts with EF >0,30 and/or LVEDD <7 cm (72%; p <0.001; SD 10%; p=0.0006). Conclusions: ns VT detected at first evaluation were not associated with a higher risk of total or sudden death; pts with a severe left ventricular dysfunction and dilatation had a worse prognosis and higher risk of SD independently from the presence of ns VT.
doi:10.1016/eupace/4.supplement_1.a21-b fatcat:ak2sc4b3u5gcdkxzlkr2h3swmi