High risk of ventricular arrhythmias in patients with nonischemic dilated cardiomyopathy presenting with syncope
Abstract
It is not entirely clear whether the presentation of syncope in patients with nonischemic dilated cardiomyopathy (NIDC) is an ominous prognostic indicator, because randomized controlled implantable cardioverter-defibrillator (ICD) trials generally exclude such patients. This study compared 108 consecutive patients with NIDC presenting with syncope with 71 consecutive patients with NIDC who presented with sustained ventricular arrhythmias, with regard to freedom from any ventricular arrhythmias or life-threatening arrhythmias and all-cause mortality. There was no significant difference between the groups in the 3 outcomes during the follow-up of 43.5 +/- 32.1 months. Male gender and ICD therapy predicted increased risk for any ventricular arrhythmias. A reduced left ventricular ejection fraction and increased age were predictive of increased mortality. In conclusion, patients with NIDC presenting with syncope are a high-risk group, with event rates similar to patients with NIDC presenting with sustained arrhythmias, and should be considered for ICD therapy.
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Data from observational studies in selected cohorts show a high rate of occurrence of ventricular arrhythmias, ICD discharge, and death in patients with a history of unexplained syncope, but owing to a lack of control groups are unable to show the benefit of an ICD.
“Data from observational studies in selected cohorts show a high rate of occurrence of ventricular arrhythmias, ICD discharge, and death in patients with a history of unexplained syncope but, owing to a lack of control groups, are unable to show the benefit of an ICD. 27,28,359,360”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [360]
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2018 ESC Guidelines for the diagnosis and management of syncope
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- Authors
- Phang, R. S., Kang, D., Tighiouart, H., Estes, N. A. M., & Link, M. S.
- Affiliations
- Tufts Medical Center (US)
- Corresponding author
- Phang, Robert S.
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2006-02
- Volume
- 97
- Issue
- 3
- Pages
- 416-420
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W1994967712
- Cited by
- 22
- References
- 29
- Citations by year
- 2023: 1 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 1 · 2015: 2 · 2014: 4 · 2013: 1 · 2012: 2
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- non-ischemic dilated cardiomyopathy, syncope, ventricular arrhythmias, implantable cardioverter-defibrillator, all-cause mortality, left ventricular ejection fraction, risk stratification
- MeSH terms
- Aged, Arrhythmias, Cardiac, Cardiomyopathy, Dilated, Female, Humans, Male, Middle Aged, Syncope, Cohort Studies
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