Key result
A history of fatal event or sustained ventricular tachycardia was the strongest predictor of major ventricular tachyarrhythmic events in patients with ARVC (OR 5.66), alongside extensive RV dysfunction and non-sustained VT.
Why the study?
Do specific clinical and electrophysiological risk factors predict major ventricular tachyarrhythmic events in patients with arrhythmogenic right ventricular cardiomyopathy?
Meta-Analysis (n=817)
Do specific clinical and electrophysiological risk factors predict major ventricular tachyarrhythmic events in patients with arrhythmogenic right ventricular cardiomyopathy?
Odds Ratio: 5.66 (95% CI 3.36–9.53)
p-value: p=<0.00001
Extensive right ventricular dysfunction, ventricular late potential, inducible ventricular tachyarrhythmia, non-sustained VT, and history of sustained VT/VF are significant predictors of major ventricular tachyarrhythmic events in patients with ARVC.
May aid ARVC risk stratification; confirms predictors in pooled observational data.
Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a cardiomyopathy characterized by predominant right ventricular fibro-fatty replacement, right ventricular dysfunction and ventricular arrhythmias. It is a rare but important cause of sudden cardiac death in children and young adults. A meta-analysis on risk stratification of major ventricular tachyarrhythmic events indicating the need for implantable cardioverter defibrillator therapy in ARVC was performed. Methods: The pubmed database was searched from its inception to May 2015. Of the 433 citations identified, 12 were included in this meta-analysis. Data regarding major ventricular tachyarrhythmic events were retrieved in 817 subjects from the studies. For the variables, a combined odds ratio (OR) was calculated using a fixed-effects meta-analysis. Results: Extensive right ventricular dysfunction (OR, 2.44), ventricular late potential (OR, 1.66), inducible ventricular tachyarrhythmia during electrophysiology study (OR, 3.67), non-sustained ventricular tachycardia (OR, 3.78), and history of fatal event/sustained VT (OR, 5.66) identified as significant risk factors (p<0.0001).
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Roh et al. (2017) conducted a meta-analysis in Arrhythmogenic right ventricular cardiomyopathy (ARVC) (n=817). History of fatal event/sustained VT vs. Absence of history of fatal event/sustained VT was evaluated on Major ventricular tachyarrhythmic events indicating ICD therapy (OR 5.66, 95% CI 3.36-9.53, p=<0.00001). A history of fatal event or sustained ventricular tachycardia was the strongest predictor of major ventricular tachyarrhythmic events in patients with ARVC (OR 5.66), alongside extensive RV dysfunction and non-sustained VT.
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