Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Postimplantation ventricular ectopic burden and clinical outcomes in cardiac resynchronization therapy-defibrillator patients: a MADIT-CRT substudy

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Minimal T-wave representation and its use in the assessment of drug arrhythmogenicity

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Validation of an automatic diagnosis of strict left bundle branch block criteria using 12-lead electrocardiograms

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Heart Rate Variability Density Analysis (Dyx) and Prediction of Long-Term Mortality after Acute Myocardial Infarction

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Specificity of elevated intercostal space ECG recording for the type 1 Brugada ECG pattern

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Rate and rhythm therapy in patients with atrial fibrillation and the risk of pacing and bradyarrhythmia

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Clinical outcome in patients with implantable cardioverter-defibrillator and cancer: a nationwide study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Risk of post-discharge fall-related injuries among adult patients with syncope: A nationwide cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Driving following defibrillator implantation: development and pilot results from a nationwide questionnaire

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: Frequent ventricular ectopy on preimplantation Holter has been associated with attenuated benefit from cardiac resynchronization therapy (CRT). However, it is unclear whether ectopic burden measured post-CRT implantation can be utilized to evaluate long-term prognosis. We aimed to describe the association between post-CRT implantation ectopic burden and subsequent risk of clinical outcomes.

METHODS: At the 12-month follow-up visit, 24-hour Holter recordings were performed in 698 CRT-D patients from the MADIT-CRT study. The mean number of ventricular premature complexes (VPCs/hour) was calculated. High ectopic burden was defined as >10 VPCs/hour and low burden as ≤10 VPCs/hour. Multivariate Cox proportional hazards models were utilized to assess the association between 12-month ectopic burden and the risk of the end points of heart failure (HF) or death and ventricular tachyarrhythmias (VT/VF).

RESULTS: At 12 months, 282 (40%) patients presented with low ectopic burden and 416 (60%) patients presented with high ectopic burden. The 3-year risk of HF/death and VT/VF was lower in patients with a low burden (7% and 8%) and significantly higher (25% and 24%) in patients with high burden. In multivariate analyses, patients with a high ectopic burden had approximately threefold increased risk of both HF/death (HR=2.76 [1.62-4.70], p < .001) and VT/VF (HR=2.79 [1.69-4.58], p < .001).

CONCLUSION: In CRT-D patients with mild heart failure, high ectopic burden at 12-month follow-up was associated with a high 3-year risk of HF/death and VT/VF and threefold increased risk as compared to patients with low burden. Ectopic burden at 12 months may be a valuable approach for evaluating long-term prognosis.

Original languageEnglish
JournalAnnals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
Volume23
Issue number2
Pages (from-to)E12491
ISSN1542-474X
DOIs
Publication statusPublished - 2018

    Research areas

  • Journal Article

ID: 52686030