A history of NSVT before CRT-D implantation did not significantly increase appropriate therapy at 24 months (26.0% vs 18.4%, P=0.22) but reduced survival free from heart failure death.
Cohort (n=269)
Yes
Does a history of NSVT predict sustained ventricular tachyarrhythmias or heart failure death in patients receiving CRT-D for primary prevention?
In patients receiving CRT-D for primary prevention, a history of NSVT predicts heart failure mortality rather than subsequent sustained ventricular tachyarrhythmias.
Absolute Event Rate: 26% vs 18.4%
p-value: p=0.22
Abstract Background Whether nonsustained ventricular tachycardia ( NSVT ) is a marker of increased risk of sustained ventricular tachyarrhythmias ( VTA s) remains to be established in patients receiving cardiac resynchronization therapy with a defibrillator ( CRT ‐D) for primary prevention. Methods Among the follow‐up data of the Japan cardiac device treatment registry ( JCDTR ) with an implantation date between January 2011 and August 2015, information regarding a history of NSVT before the CRT ‐D implantation for primary prevention had been registered in 269 patients. Outcomes were compared between two groups with and without NSVT : NSVT group (n = 179) and No NSVT group (n = 90). Results There was no significant difference with regard to age, gender, and NYHA class between the two groups. Left ventricular ejection fraction ( LVEF ) was 25.6% in the NSVT group and 28.0% in the No NSVT group ( P = .046). The rate of appropriate therapy at 24 months was 26.0% and 18.4% in the NSVT and No NSVT groups ( P = .22), respectively. Survival free from heart failure death was reduced in the NSVT group, as compared with the No NSVT group, with the rate of 90.2% vs 97.2% at 24 months ( P = .030). A multivariate analysis identified a history of NSVT , anemia, and no use of angiotensin‐converting enzyme inhibitor ( ACEI ) or angiotensin‐receptor blocker ( ARB ) as predictors of heart failure death. Conclusions NSVT appears to be a surrogate marker of severe heart failure rather than a substrate for subsequent sustained VTA s in patients with CRT ‐D for primary prevention.
Yokoshiki et al. (2018) conducted a cohort in Primary prevention with cardiac resynchronization therapy with a defibrillator (CRT-D) (n=269). History of nonsustained ventricular tachycardia (NSVT) vs. No history of NSVT was evaluated on Appropriate therapy (p=0.22). A history of NSVT before CRT-D implantation did not significantly increase appropriate therapy at 24 months (26.0% vs 18.4%, P=0.22) but reduced survival free from heart failure death.
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