Does the presence of complex ventricular arrhythmias correlate with depressed ventricular function and poor prognosis in patients with dilated cardiomyopathy?
Complex ventricular arrhythmias are highly prevalent in dilated cardiomyopathy and are associated with worse ventricular function and higher mortality.
Summary Sixty-five patients with dilated cardiomyopathy underwent 24 hour electrocardiographic monitoring: 62 (95.4%) showed ventricular arrhythmias and 52 (80%) complex ventricular arrhythmias (multiform ventricular extrasystoles, paired ventricular extrasystoles and ventricular tachycardia). Complex ventricular arrhythmias correlated significantly with some haemodynamic indices of ventricular dysfunction: patients with multiform and paired ventricular extrasystoles and with ventricular tachycardia had lower values of ejection fraction (31.9 ± 11.8%, P = 0.002) and of cardiac index (2.9 ± 0.7 litres/min/m2, P = 0.029) than the others (41.1 ± 11.1% and 3.5 ± 0.9 litres/min/m2 respectively). Patients were followed for a period of 30 ± 18 months (20 days to 64 months). During follow-up 19 died and mortality was higher among patients with multiform and paired ventricular extrasystoles and/or ventricular tachycardia. Complex ventricular arrhythmias are frequent in dilated cardiomyopathy: ventricular tachycardia and multiform and paired ventricular extrasystoles seem to be related to a more depressed ventricular function and to a poor prognosis. The importance of antiarrhythmic treatment in these patients has still to be evaluated.
Neri et al. (Sun,) studied this question.
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