TY - JOUR
T1 - Prognosis After Finding Incidental Ventricular Tachycardia on Ambulatory Electrocardiogram-recording
AU - Sadjadieh, Golnaz
AU - Sajadieh, Ahmad
N1 - Copyright © 2021 Elsevier Inc. All rights reserved.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - The prognostic significance of incidental non-sustained ventricular tachycardia (NSVT) in subjects without apparent heart disease is unknown. We aimed to evaluate short- and long-term prognosis of NSVT in the Copenhagen Holter Study cohort. From the study, 678 middle-aged and elderly subjects had minimum 48 hours of Holter-recording, laboratory testing and physician-based examination and questionnaire performed. Median follow-up time was 14.7 years. NSVT was defined as runs of minimum three premature ventricular complexes. The primary end-point was a combination of cardiovascular mortality, acute myocardial infarction, coronary revascularization or stroke. Secondary endpoints were all-cause mortality and components of the primary end-point. We found that 72 (10.6%) had minimum one NSVT event on 48-hour Holter-recording. The primary end-point occurred more frequently in patients with NSVT than those without: 38.3 versus 17.7 events per 1,000 patient-years, hazard ratio 2.1, 95% CI 1.37 to 3.20 after adjustment for risk factors. Secondary end-points also occurred more frequently in the NSVT-group. A shorter-term follow-up revealed similar event rates for the primary outcome; 47.5 versus 21.2 events per 1,000 patient-years, hazard ratio 1.9, 95% CI 0.69 to 5.24. Besides stroke other secondary end-points occurred more frequently in the short-term follow-up. The prognosis in subjects with NSVT was not dependent of the length of the VT. In conclusion, incidental asymptomatic NSVT on Holter-recording in subjects without apparent or manifest structural heart disease is associated with increased risk of mortality and cardiovascular events, however the increased risk is not imminent but with a slow and steady pace over time.
AB - The prognostic significance of incidental non-sustained ventricular tachycardia (NSVT) in subjects without apparent heart disease is unknown. We aimed to evaluate short- and long-term prognosis of NSVT in the Copenhagen Holter Study cohort. From the study, 678 middle-aged and elderly subjects had minimum 48 hours of Holter-recording, laboratory testing and physician-based examination and questionnaire performed. Median follow-up time was 14.7 years. NSVT was defined as runs of minimum three premature ventricular complexes. The primary end-point was a combination of cardiovascular mortality, acute myocardial infarction, coronary revascularization or stroke. Secondary endpoints were all-cause mortality and components of the primary end-point. We found that 72 (10.6%) had minimum one NSVT event on 48-hour Holter-recording. The primary end-point occurred more frequently in patients with NSVT than those without: 38.3 versus 17.7 events per 1,000 patient-years, hazard ratio 2.1, 95% CI 1.37 to 3.20 after adjustment for risk factors. Secondary end-points also occurred more frequently in the NSVT-group. A shorter-term follow-up revealed similar event rates for the primary outcome; 47.5 versus 21.2 events per 1,000 patient-years, hazard ratio 1.9, 95% CI 0.69 to 5.24. Besides stroke other secondary end-points occurred more frequently in the short-term follow-up. The prognosis in subjects with NSVT was not dependent of the length of the VT. In conclusion, incidental asymptomatic NSVT on Holter-recording in subjects without apparent or manifest structural heart disease is associated with increased risk of mortality and cardiovascular events, however the increased risk is not imminent but with a slow and steady pace over time.
KW - Aged
KW - Denmark/epidemiology
KW - Electrocardiography, Ambulatory
KW - Female
KW - Humans
KW - Incidental Findings
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/diagnosis
KW - Prognosis
KW - Risk Factors
KW - Surveys and Questionnaires
KW - Tachycardia, Ventricular/diagnosis
KW - Ventricular Premature Complexes/diagnosis
UR - http://www.scopus.com/inward/record.url?scp=85105870332&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2021.03.049
DO - 10.1016/j.amjcard.2021.03.049
M3 - Journal article
C2 - 34001341
SN - 0002-9149
VL - 150
SP - 60
EP - 64
JO - The American journal of cardiology
JF - The American journal of cardiology
ER -