Ethan J Rowin, Gaurav Das, Christopher Madias, Mike Hsu, Lori Crosson, Mintu P Turakhia, Barry J Maron, Martin S Maron
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引用次数: 0
Abstract
Background: In hypertrophic cardiomyopathy (HCM), 48-hour ambulatory monitoring has been standard practice to detect nonsustained ventricular tachycardia (NSVT), a sudden death risk marker. Extended wear ambulatory ECG devices have more recently utilized for monitoring HCM patients.
Objective: Evaluate NSVT burden identified with continuous ambulatory monitoring for up to 2 weeks compared to initial 48 hours.
Methods: 236 consecutive HCM patients (49 ± 12 years) underwent 14-day continuous ambulatory monitoring (Zio XT, iRhythm Technologies); diagnostic yield of NSVT compared for initial 48 hours vs. extended for 14 days.
Results: Of 236 patients, 114 (48%) had ≥1 runs of NSVT (median 2) over 14 days. Median length of NSVT was 7 beats (range: 3 to 67) at rates of 120 to 240 bpm (median, 167 bpm). In 42 of the 114 patients (37%), initial NSVT occurred ≤ 48 hours and in 72 (63%) only during the extended monitoring period (3 to 14 days). Diagnostic yield for detecting NSVT over 14 days was 2.7-fold greater than ≤ 48 hours (p<0.001). NSVT judged at higher risk (≥8 beats, >200 bpm, ≥2 runs in consecutive 2-day period) was identified more frequently during extended monitoring, diagnostic yield 3.0-fold greater than ≤ 48 hours (p<0.001).
Conclusion: In HCM, NSVT episodes are frequent, however, in most patients, both NSVT and higher risk NSVT were not detected during initial 48-hours and confined solely to extended monitoring period. These data support additional clinical studies to evaluate the significance of NSVT on extended monitoring on sudden death risk in HCM.
期刊介绍:
HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability.
HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community.
The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.