Prognosis of programmed ventricular stimulation in adult patients with syncope of unexplained origin: A historical cohort
Abstract Background Programmed ventricular stimulation (PVS) during electrophysiological study (EPS), is a globally accepted tool for risk stratification of sudden cardiac death (SCD) in some specific clinical situations. The aim of this study was to evaluate the prognosis of ventricular arrhythmia...
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Wiley
2024-02-01
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| Series: | Journal of Arrhythmia |
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| Online Access: | https://doi.org/10.1002/joa3.12953 |
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| author | Bruno Schaaf Finkler Roberto Sant'Anna Javier Pinos Danilo Barros Zanotta Thiago Camargo Moreira Felipe Della Barba deJesus Pedro Dutra Batista Helena Guedes daRocha Barbara Adelmann deLima Marco Aurélio Lumertz Saffi Gustavo Glotz deLima Marcelo Kruse Tiago Luiz Luz Leiria |
| author_facet | Bruno Schaaf Finkler Roberto Sant'Anna Javier Pinos Danilo Barros Zanotta Thiago Camargo Moreira Felipe Della Barba deJesus Pedro Dutra Batista Helena Guedes daRocha Barbara Adelmann deLima Marco Aurélio Lumertz Saffi Gustavo Glotz deLima Marcelo Kruse Tiago Luiz Luz Leiria |
| author_sort | Bruno Schaaf Finkler |
| collection | DOAJ |
| description | Abstract Background Programmed ventricular stimulation (PVS) during electrophysiological study (EPS), is a globally accepted tool for risk stratification of sudden cardiac death (SCD) in some specific clinical situations. The aim of this study was to evaluate the prognosis of ventricular arrhythmia induction in a cohort of patients with syncope of undetermined origin (SUO). Methods This is a historical cohort study in a population of patients with SUO referred for EPS between the years 2008–2021. In this interval, 575 patients underwent the procedure. Results Patients with induced ventricular arrhythmias had a higher occurrence of structural heart disease (36.7% vs. 76.5%), ischemic heart disease (28.2 vs. 57.1%), heart failure (15.5% vs. 34.4%), and lower left ventricular ejection fraction (59.16% vs. 47.51%), when compared to the outcome with a negative study. PVS triggered ventricular arrhythmias in 98 patients, 62 monomorphic and 36 polymorphic. During a median follow‐up of 37.6 months, 100 deaths occurred. Only the induction of sustained ventricular arrhythmias showed a significant association with the primary outcome (all‐cause mortality) with a p value <.001. After the performance of EPS, 142 patients underwent cardioverter‐defibrillator (ICD) implantation. At study follow‐up, 30 patients had therapies by the device. Only the induction of sustained monomorphic ventricular arrhythmia showed statistically significant association with appropriate therapies by the device (p = .012). Conclusion In patients with SUO, the induction of sustained monomorphic ventricular arrhythmia after programmed ventricular pacing is related to a worse prognosis, with a higher incidence of mortality and appropriate therapies by the ICD. |
| format | Article |
| id | doaj-art-60e7a53b78e74ea9b0b97aec4c642208 |
| institution | Matheson Library |
| issn | 1880-4276 1883-2148 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | Wiley |
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| series | Journal of Arrhythmia |
| spelling | doaj-art-60e7a53b78e74ea9b0b97aec4c6422082025-07-22T04:20:48ZengWileyJournal of Arrhythmia1880-42761883-21482024-02-0140112413010.1002/joa3.12953Prognosis of programmed ventricular stimulation in adult patients with syncope of unexplained origin: A historical cohortBruno Schaaf Finkler0Roberto Sant'Anna1Javier Pinos2Danilo Barros Zanotta3Thiago Camargo Moreira4Felipe Della Barba deJesus5Pedro Dutra Batista6Helena Guedes daRocha7Barbara Adelmann deLima8Marco Aurélio Lumertz Saffi9Gustavo Glotz deLima10Marcelo Kruse11Tiago Luiz Luz Leiria12Instituto de Cardiologia do Rio Grande, do Sul, Fundação Universitária de Cardiologia Porto Alegre RS BrazilInstituto de Cardiologia do Rio Grande, do Sul, Fundação Universitária de Cardiologia Porto Alegre RS BrazilInstituto de Cardiologia do Rio Grande, do Sul, Fundação Universitária de Cardiologia Porto Alegre RS BrazilInstituto de Cardiologia do Rio Grande, do Sul, Fundação Universitária de Cardiologia Porto Alegre RS BrazilInstituto de Cardiologia do Rio Grande, do Sul, Fundação Universitária de Cardiologia Porto Alegre RS BrazilUniversidade Federal de Ciências da Saúde de Porto Alegre Porto Alegre RS BrazilUniversidade Federal de Ciências da Saúde de Porto Alegre Porto Alegre RS BrazilUniversidade Federal de Ciências da Saúde de Porto Alegre Porto Alegre RS BrazilInstituto de Cardiologia do Rio Grande, do Sul, Fundação Universitária de Cardiologia Porto Alegre RS BrazilHospital de Clínicas de Porto Alegre Porto Alegre RS BrazilInstituto de Cardiologia do Rio Grande, do Sul, Fundação Universitária de Cardiologia Porto Alegre RS BrazilInstituto de Cardiologia do Rio Grande, do Sul, Fundação Universitária de Cardiologia Porto Alegre RS BrazilInstituto de Cardiologia do Rio Grande, do Sul, Fundação Universitária de Cardiologia Porto Alegre RS BrazilAbstract Background Programmed ventricular stimulation (PVS) during electrophysiological study (EPS), is a globally accepted tool for risk stratification of sudden cardiac death (SCD) in some specific clinical situations. The aim of this study was to evaluate the prognosis of ventricular arrhythmia induction in a cohort of patients with syncope of undetermined origin (SUO). Methods This is a historical cohort study in a population of patients with SUO referred for EPS between the years 2008–2021. In this interval, 575 patients underwent the procedure. Results Patients with induced ventricular arrhythmias had a higher occurrence of structural heart disease (36.7% vs. 76.5%), ischemic heart disease (28.2 vs. 57.1%), heart failure (15.5% vs. 34.4%), and lower left ventricular ejection fraction (59.16% vs. 47.51%), when compared to the outcome with a negative study. PVS triggered ventricular arrhythmias in 98 patients, 62 monomorphic and 36 polymorphic. During a median follow‐up of 37.6 months, 100 deaths occurred. Only the induction of sustained ventricular arrhythmias showed a significant association with the primary outcome (all‐cause mortality) with a p value <.001. After the performance of EPS, 142 patients underwent cardioverter‐defibrillator (ICD) implantation. At study follow‐up, 30 patients had therapies by the device. Only the induction of sustained monomorphic ventricular arrhythmia showed statistically significant association with appropriate therapies by the device (p = .012). Conclusion In patients with SUO, the induction of sustained monomorphic ventricular arrhythmia after programmed ventricular pacing is related to a worse prognosis, with a higher incidence of mortality and appropriate therapies by the ICD.https://doi.org/10.1002/joa3.12953cohort studieselectrophysiologic studyprognosissyncopeventricular tachycardia |
| spellingShingle | Bruno Schaaf Finkler Roberto Sant'Anna Javier Pinos Danilo Barros Zanotta Thiago Camargo Moreira Felipe Della Barba deJesus Pedro Dutra Batista Helena Guedes daRocha Barbara Adelmann deLima Marco Aurélio Lumertz Saffi Gustavo Glotz deLima Marcelo Kruse Tiago Luiz Luz Leiria Prognosis of programmed ventricular stimulation in adult patients with syncope of unexplained origin: A historical cohort Journal of Arrhythmia cohort studies electrophysiologic study prognosis syncope ventricular tachycardia |
| title | Prognosis of programmed ventricular stimulation in adult patients with syncope of unexplained origin: A historical cohort |
| title_full | Prognosis of programmed ventricular stimulation in adult patients with syncope of unexplained origin: A historical cohort |
| title_fullStr | Prognosis of programmed ventricular stimulation in adult patients with syncope of unexplained origin: A historical cohort |
| title_full_unstemmed | Prognosis of programmed ventricular stimulation in adult patients with syncope of unexplained origin: A historical cohort |
| title_short | Prognosis of programmed ventricular stimulation in adult patients with syncope of unexplained origin: A historical cohort |
| title_sort | prognosis of programmed ventricular stimulation in adult patients with syncope of unexplained origin a historical cohort |
| topic | cohort studies electrophysiologic study prognosis syncope ventricular tachycardia |
| url | https://doi.org/10.1002/joa3.12953 |
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