Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: results from a multicentre long-term registry

Giulio Conte, Bernard Belhassen, Pier Lambiase, Giuseppe Ciconte, Carlo de Asmundis, Elena Arbelo, Beat Schaer, Antonio Frontera, Haran Burri, Leonardo Calo', Kostantinos P Letsas, Francisco Leyva, Bradley Porter, Johan Saenen, Valerio Zacà, Paola Berne, Peter Ammann, Marco Zardini, Blerim Luani, Roberto RordorfGeorgia Sarquella Brugada, Argelia Medeiros-Domingo, Johann-Christoph Geller, Tom de Potter, Mathis K Stokke, Manlio F Márquez, Yoav Michowitz, Shohreh Honarbakhsh, Manuel Conti, Christian Sticherling, Annamaria Martino, Abbasin Zegard, Tardu Özkartal, Maria Luce Caputo, François Regoli, Rüdiger C Braun-Dullaeus, Francesca Notarangelo, Tiziano Moccetti, Gavino Casu, Christopher A Rinaldi, Moises Levinstein, Kristina H Haugaa, Nicolas Derval, Catherine Klersy, Moreno Curti, Carlo Pappone, Hein Heidbuchel, Josép Brugada, Michel Haïssaguerre, Pedro Brugada, Angelo Auricchio

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)

Abstract

AIMS: To define the clinical characteristics and long-term clinical outcomes of a large cohort of patients with idiopathic ventricular fibrillation (IVF) and normal 12-lead electrocardiograms (ECGs).

METHODS AND RESULTS: Patients with ventricular fibrillation as the presenting rhythm, normal baseline, and follow-up ECGs with no signs of cardiac channelopathy including early repolarization or atrioventricular conduction abnormalities, and without structural heart disease were included in a registry. A total of 245 patients (median age: 38 years; males 59%) were recruited from 25 centres. An implantable cardioverter-defibrillator (ICD) was implanted in 226 patients (92%), while 18 patients (8%) were treated with drug therapy only. Over a median follow-up of 63 months (interquartile range: 25-110 months), 12 patients died (5%); in four of them (1.6%) the lethal event was of cardiac origin. Patients treated with antiarrhythmic drugs only had a higher rate of cardiovascular death compared to patients who received an ICD (16% vs. 0.4%, P = 0.001). Fifty-two patients (21%) experienced an arrhythmic recurrence. Age ≤16 years at the time of the first ventricular arrhythmia was the only predictor of arrhythmic recurrence on multivariable analysis [hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.18-0.92; P = 0.03].

CONCLUSION: Patients with IVF and persistently normal ECGs frequently have arrhythmic recurrences, but a good prognosis when treated with an ICD. Children are a category of IVF patients at higher risk of arrhythmic recurrences.

Original languageEnglish
Pages (from-to)1670-1677
Number of pages8
JournalEuropace
Volume21
Issue number11
Early online date25 Aug 2019
DOIs
Publication statusPublished - 1 Nov 2019

Bibliographical note

© The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.

Keywords

  • Electrocardiography
  • Idiopathic ventricular fibrillation
  • Implantable cardioverter-defibrillator
  • Out-of-hospital cardiac arrest
  • Quinidine
  • Sudden cardiac death

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