Key result
Exercise-induced ventricular arrhythmias linked to ~180% higher risk of major arrhythmic events.
Why the study?
Exercise has the potential to unmask ventricular arrhythmias in ACM, but the prevalence and prognostic significance of exercise-induced ventricular arrhythmias during exercise testing required assessment.
Does the presence of exercise-induced ventricular arrhythmias predict adverse arrhythmic outcomes in patients with arrhythmogenic cardiomyopathy?
Population
157 patients with definitive ACM or pathogenic/likely pathogenic variants with negative/borderline phenotype
Comparison
Exercise-induced ventricular arrhythmias (grade ≥2) vs absence of EIVA
Design
Retrospective cohort study
Authors
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Myocardial fibrosis may refine arrhythmic risk stratification in arrhythmogenic cardiomyopathy; leaves open prospective validation before guiding therapy.
Cohort (n=157)
No
Does the presence of exercise-induced ventricular arrhythmias predict adverse arrhythmic outcomes in patients with arrhythmogenic cardiomyopathy?
Hazard Ratio: 2.8 (95% CI 1.1–7.3)
p-value: p=0.03
Exercise-induced ventricular arrhythmias are present in nearly one-third of ACM patients and serve as an independent predictor of adverse arrhythmic events, supporting the use of exercise testing for risk stratification.
Mengozzi et al. (2026) conducted a cohort in Arrhythmogenic cardiomyopathy (n=157). Exercise-induced ventricular arrhythmias (EIVA) vs. Absence of EIVA was evaluated on Composite of sustained ventricular tachycardia/fibrillation, appropriate implantable cardioverter-defibrillator therapy, sudden cardiac arrest and sudden death (HR 2.8, 95% CI 1.1-7.3, p=0.03). Exercise-induced ventricular arrhythmias were independently associated with a higher risk of the primary arrhythmic composite endpoint (HR 2.8; 95% CI 1.1-7.3; p=0.03).
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