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Idiopathic ventricular fibrillation – Long term prognosis in relation to clinical findings and ECG patterns in a Swedish cohort

Chaudhry, U. LU ; Platonov, P. G. LU ; Rubulis, A. ; Bergfeldt, L. ; Jensen, S. M. ; Lundin, C. LU and Borgquist, R. LU orcid (2019) In Journal of Electrocardiology 56. p.46-51
Abstract

Background: Idiopathic ventricular fibrillation (IVF) is a rare cause of sudden cardiac arrest which may pose therapeutic and prognostic challenges. To date, the only effective treatment for survivors of cardiac arrest is the insertion of an implantable cardioverter-defibrillator (ICD). We sought to review the long-term outcome of a Swedish cohort with IVF. Methods and results: Fifty patients with IVF diagnosis between 1988 and 2016 (mean age at index 34.3, 56% male), were followed for a median 13.8 years in this retrospective multicenter observational study. No cardiac mortality was reported. 32% (n = 16) of patients had recurrence of ventricular fibrillation or sustained ventricular tachycardia, requiring ICD therapy, at a median time... (More)

Background: Idiopathic ventricular fibrillation (IVF) is a rare cause of sudden cardiac arrest which may pose therapeutic and prognostic challenges. To date, the only effective treatment for survivors of cardiac arrest is the insertion of an implantable cardioverter-defibrillator (ICD). We sought to review the long-term outcome of a Swedish cohort with IVF. Methods and results: Fifty patients with IVF diagnosis between 1988 and 2016 (mean age at index 34.3, 56% male), were followed for a median 13.8 years in this retrospective multicenter observational study. No cardiac mortality was reported. 32% (n = 16) of patients had recurrence of ventricular fibrillation or sustained ventricular tachycardia, requiring ICD therapy, at a median time of 1.9 years (range 0.1–20.3) from the index event. Annual incidence rate of ventricular tachyarrhythmia was 3.1%. Abnormal ECG at baseline did not predict appropriate ICD therapy (p = 0.56). During the follow-up period, 14% (n = 7) patients received a cardiac diagnosis. Follow-up genetic testing was low (26%), however did confirm pathogenic mutations in three cases. Conclusion: Idiopathic VF is a rare diagnosis with a relatively good prognosis provided ICD therapy is initiated. Routine clinical follow-up is recommended due to potential late emerging cardiac pathology. ECG changes are common, but have no prognostic value in determining the risk of ventricular arrhythmias recurrence. Screening for genetic diseases has previously been low, and this calls for improvement, especially since cheaper and more comprehensive genetic panels are now readily available.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ECG abnormalities, Follow-up, Genetic testing, Implantable cardioverter-defibrillator, Sudden cardiac death, Ventricular fibrillation
in
Journal of Electrocardiology
volume
56
pages
6 pages
publisher
Elsevier
external identifiers
  • scopus:85068267796
  • pmid:31280131
ISSN
0022-0736
DOI
10.1016/j.jelectrocard.2019.06.016
language
English
LU publication?
yes
id
d11e84ab-83e5-4425-b02f-43e2c76f6b30
date added to LUP
2019-07-09 09:45:54
date last changed
2024-04-30 17:41:12
@article{d11e84ab-83e5-4425-b02f-43e2c76f6b30,
  abstract     = {{<p>Background: Idiopathic ventricular fibrillation (IVF) is a rare cause of sudden cardiac arrest which may pose therapeutic and prognostic challenges. To date, the only effective treatment for survivors of cardiac arrest is the insertion of an implantable cardioverter-defibrillator (ICD). We sought to review the long-term outcome of a Swedish cohort with IVF. Methods and results: Fifty patients with IVF diagnosis between 1988 and 2016 (mean age at index 34.3, 56% male), were followed for a median 13.8 years in this retrospective multicenter observational study. No cardiac mortality was reported. 32% (n = 16) of patients had recurrence of ventricular fibrillation or sustained ventricular tachycardia, requiring ICD therapy, at a median time of 1.9 years (range 0.1–20.3) from the index event. Annual incidence rate of ventricular tachyarrhythmia was 3.1%. Abnormal ECG at baseline did not predict appropriate ICD therapy (p = 0.56). During the follow-up period, 14% (n = 7) patients received a cardiac diagnosis. Follow-up genetic testing was low (26%), however did confirm pathogenic mutations in three cases. Conclusion: Idiopathic VF is a rare diagnosis with a relatively good prognosis provided ICD therapy is initiated. Routine clinical follow-up is recommended due to potential late emerging cardiac pathology. ECG changes are common, but have no prognostic value in determining the risk of ventricular arrhythmias recurrence. Screening for genetic diseases has previously been low, and this calls for improvement, especially since cheaper and more comprehensive genetic panels are now readily available.</p>}},
  author       = {{Chaudhry, U. and Platonov, P. G. and Rubulis, A. and Bergfeldt, L. and Jensen, S. M. and Lundin, C. and Borgquist, R.}},
  issn         = {{0022-0736}},
  keywords     = {{ECG abnormalities; Follow-up; Genetic testing; Implantable cardioverter-defibrillator; Sudden cardiac death; Ventricular fibrillation}},
  language     = {{eng}},
  pages        = {{46--51}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Electrocardiology}},
  title        = {{Idiopathic ventricular fibrillation – Long term prognosis in relation to clinical findings and ECG patterns in a Swedish cohort}},
  url          = {{http://dx.doi.org/10.1016/j.jelectrocard.2019.06.016}},
  doi          = {{10.1016/j.jelectrocard.2019.06.016}},
  volume       = {{56}},
  year         = {{2019}},
}