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August 22, 2016PLoS ONE58 citationsOpen Access

Long-Term Outcome of Non-Sustained Ventricular Tachycardia in Structurally Normal Hearts

CLChin‐Yu LinSCShih‐Lin ChangFCFa‐Po Chung

Key Result

In patients without structural heart disease, the presence of non-sustained ventricular tachycardia was independently associated with an increased risk of all-cause mortality (HR 1.362).

Study Design

Type

Cohort (n=3,767)

Multicenter

No

Structured PICO

Does the presence of non-sustained ventricular tachycardia predict adverse clinical outcomes in patients with structurally normal hearts?

P
Population
3,767 patients without structural heart disease or sustained ventricular tachycardia referred for 24-hour ECG monitoring, followed for a mean of 10 years.
E
Exposure
Presence of non-sustained ventricular tachycardia (NSVT) on 24-hour Holter monitoring, defined as 3 or more consecutive beats arising below the atrioventricular node with an RR interval <600 ms and lasting <30 seconds.
C
Comparator
Absence of non-sustained ventricular tachycardia on 24-hour Holter monitoring.
O
Outcome
All-cause mortalityhard clinical

In patients with structurally normal hearts, the presence of non-sustained ventricular tachycardia on 24-hour monitoring is independently associated with increased long-term risks of mortality, cardiovascular hospitalization, stroke, TIA, and new-onset heart failure.

Main Result

Hazard Ratio: 1.362 (95% CI 1.071–1.731)

Absolute Event Rate: 35.5% vs 19.7%

p-value: p=0.012

Limitations

  • Sicker patients were followed more frequently and had an increased likelihood of hospitalization
  • Patients were referred for Holter monitoring for various indications, and NSVT could reflect the severity of underlying diseases
  • Other unmeasured confounding factors might exist
  • Patients' characteristics were distinctly different between the two groups
  • Interactions among different secondary endpoints could not be fully adjusted
  • Burden of ventricular ectopy was low at enrollment
  • Unmeasured confounding factors might exist
  • Patient characteristics were distinctly different between the two groups

Abstract

BACKGROUND: The impact of non-sustained ventricular tachycardia (NSVT) on the risk of thromboembolic event and clinical outcomes in patients without structural heart disease remains undetermined. This study aimed to evaluate the association between NSVT and clinical outcomes. METHODS: The study population of 5903 patients was culled from the "Registry of 24-hour ECG monitoring at Taipei Veterans General Hospital" (REMOTE database) between January 1, 2002 and December 31, 2004. Of that total, we enrolled 3767 patients without sustained ventricular tachycardia, structural heart disease, and permanent pacemaker. For purposes of this study, NSVT was defined as 3 or more consecutive beats arising below the atrioventricular node with an RR interval of 100 beats/min) and lasting < 30 seconds. RESULT: There were 776 deaths, 2042 hospitalizations for any reason, 638 cardiovascular (CV)-related hospitalizations, 350 ischemic strokes, 409 transient ischemic accident (TIA), 368 new-onset heart failure (HF), and 260 new-onset atrial fibrillation (AF) with a mean follow-up duration of 10 ± 1 years. In multivariate analysis, the presence of NSVT was independently associated with death (hazard ratio HR: 1.362, 95% confidence interval CI: 1.071-1.731), CV hospitalization (HR: 1.527, 95% CI: 1.171-1.992), ischemic stroke (HR: 1.436, 95% CI: 1.014-2.032), TIA (HR 1.483, 95% CI: 1.069-2.057), and new-onset HF (HR: 1.716, 95% CI: 1.243-2.368). There was no significant association between the presence of NSVT and all-cause hospitalization or new-onset AF. CONCLUSION: In patients without structural heart disease, presence of NSVT on 24-hour monitoring was independently associated with death, CV hospitalization, ischemic stroke, TIA, and new onset heart failure.

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Cite This Study

Lin et al. (2016) conducted a cohort in Structurally normal hearts (n=3,767). Non-sustained ventricular tachycardia (NSVT) vs. Absence of NSVT was evaluated on All-cause mortality (HR 1.362, 95% CI 1.071-1.731, p=0.012). In patients without structural heart disease, the presence of non-sustained ventricular tachycardia was independently associated with an increased risk of all-cause mortality (HR 1.362).

synapsesocial.com/papers/6a211de423521dddf4c3c8dbhttps://doi.org/10.1371/journal.pone.0160181
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