Abstract 14065: Asymptomatic Nonsustained Ventricular Tachycardia Detected on Pacemaker Interrogation Not Associated With Adverse Outcomes and Treatment Remains Unproven
Introduction: Nonsustained ventricular tachycardia (NSVT) is frequently identified in patients with permanent pacemakers (PPMs), but its associated features, prognostic relevance and benefit of treatment remain unclear.
Objective: To determine if asymptomatic NSVT on PPM interrogation is associated with poorer patient outcome and explore the effects of antiarrhythmic therapy.
Methods: As part of a prospective cohort study, 582 PPM patients were recruited between Jan 2008 and Dec 2012 and followed for 4 ± 0.08 year (mean ± SEM). NSVT was defined as ≥3 consecutive ventricular beats at ≥100beat/min lasting <30 sec and assessed by two independent observers. Antiarrhythmic drug dose changes within six month of NSVT detection were also explored.
Results: Overall, 17 patients were excluded: lost to follow-up (n=7), PPM incapable of detecting NSVT (n=5) and incomplete NSVT data (n=5). The remaining 565 patients (57% male, age 74.4 ± 0.81 year, left ventricular ejection fraction (LVEF) 49.8% ± 0.48), had their PPM 9.8 ± 0.22 year with 72.3% ± 0.30 right ventricular pacing. Participants excluded were not different in terms of age, medication use and important clinical variables. NSVT was noted in 125 (22.1%) with higher prevalence in men than women (25.4% v 17.9%; p=0.033). Age, LVEF, cardiovascular comorbidities (hypertension, atrial fibrillation, diabetes) or medication use were not different between the groups, although those with NSVT were more likely to have had a previous myocardial infarction (p=0.018). After correction, NSVT had no impact on survival (figure 1). B-Blocker or amiodarone therapy started or increased in 39 (31.2% with NSVT) was not associated with a reduction of NSVT episodes (p=0.288) or improved survival in those with (p=0.872) or without left ventricular dysfunction (p=0.801).
Conclusions: Asymptomatic NSVT identified on PPM interrogation does not appear to be associated with adverse outcomes and treatment to suppress this arrhythmia remains unproven.
Author Disclosures: S. Mohammed: None. J. Gierula: Other Research Support; Modest; NIHR-HCS Fellowship Award. H.A. Jamil: None. M.F. Paton: Other Research Support; Modest; Funded by a Leeds Charitable Foundation Fellowship. J.E. Lowry: None. R.M. Cubbon: Other Research Support; Modest; Intermediate Fellowship from the British Heart Foundation. M.T. Kearney: Employment; Modest; British Heart Foundation Professor of Cardiology. K.K. Witte: Other Research Support; Modest; NIHR Clinician Scientist Award.
- © 2016 by American Heart Association, Inc.