open access

Vol 67, No 8 (2009)
Other
Published online: 2009-09-09
Submitted: 2012-12-28
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Original article
Recurrence of ventricular arrhythmias in patients with non-ischaemic dilated cardiomyopathy: evidence-based predictors

Elżbieta Dułak, Andrzej Lubiński, Andrzej Bissinger, Andrzej Przybylski, Maciej Sterliński, Artur Filipecki, Anna Pazdyga, Agnieszka Zienciuk, Maciej Kempa, Tomasz Królak, Hanna Szwed, Maria Trusz-Gluza, Włodzimierz Kargul
Kardiol Pol 2009;67(8):837-844.

open access

Vol 67, No 8 (2009)
Other
Published online: 2009-09-09
Submitted: 2012-12-28

Abstract


Background: Ventricular arrhythmia (VA) is the most frequent cause of sudden death among patients with non-ischaemic dilated cardiomyopathy (DCM).
Aim: To identify the important VA risk factors in patients with DCM.
Methods and results: Eighty-five DCM patients (73 males, mean age 54 years) with DCM and implantable cardioverter defibrillators (ICD) were followed for 21 ± 19 months after ICD implantation. The mean follow-up was 21 months. Data from 55 patients with VA recorded in the ICD memory and requring ICD intervention during follow-up were compared with 30 patients without arrhythmia. Cox regression analysis identified the following univariate predictors of VA: alcoholic aetiology of DCM (0.05), diuretic treatment (0.003), history of cardiac arrest (0.03), right ventricular diastolic diameter (0.001). Both ACE inhibitor (ACEI) and statin treatments were associated with a tendency towards decreased risk of VA. Multivariate logistic analysis identified four predictors as significantly related to VA: alcoholic aetiology (HR 4.8, p = 0.008), ACEI treatment (HR 0.4, p = 0.01), diuretic treatment (HR 2.6, p = 0.015), and statin treatment (HR 0.1, p = 0.03).
Conclusions: The majority of patients with DCM and ICD have recurrences of VA. Alcoholic aetiology of DCM is associated with an increase in the incidence of arrhythmias. Treatment with ACEI and statins is associated with a reduction of arrhythmias.

Abstract


Background: Ventricular arrhythmia (VA) is the most frequent cause of sudden death among patients with non-ischaemic dilated cardiomyopathy (DCM).
Aim: To identify the important VA risk factors in patients with DCM.
Methods and results: Eighty-five DCM patients (73 males, mean age 54 years) with DCM and implantable cardioverter defibrillators (ICD) were followed for 21 ± 19 months after ICD implantation. The mean follow-up was 21 months. Data from 55 patients with VA recorded in the ICD memory and requring ICD intervention during follow-up were compared with 30 patients without arrhythmia. Cox regression analysis identified the following univariate predictors of VA: alcoholic aetiology of DCM (0.05), diuretic treatment (0.003), history of cardiac arrest (0.03), right ventricular diastolic diameter (0.001). Both ACE inhibitor (ACEI) and statin treatments were associated with a tendency towards decreased risk of VA. Multivariate logistic analysis identified four predictors as significantly related to VA: alcoholic aetiology (HR 4.8, p = 0.008), ACEI treatment (HR 0.4, p = 0.01), diuretic treatment (HR 2.6, p = 0.015), and statin treatment (HR 0.1, p = 0.03).
Conclusions: The majority of patients with DCM and ICD have recurrences of VA. Alcoholic aetiology of DCM is associated with an increase in the incidence of arrhythmias. Treatment with ACEI and statins is associated with a reduction of arrhythmias.
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Keywords

cardiomyopathy; arrhythmia; risk factors; implantable cardioverter defibrillator; sudden death

About this article
Title

Original article
Recurrence of ventricular arrhythmias in patients with non-ischaemic dilated cardiomyopathy: evidence-based predictors

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 67, No 8 (2009)

Pages

837-844

Published online

2009-09-09

Bibliographic record

Kardiol Pol 2009;67(8):837-844.

Keywords

cardiomyopathy
arrhythmia
risk factors
implantable cardioverter defibrillator
sudden death

Authors

Elżbieta Dułak
Andrzej Lubiński
Andrzej Bissinger
Andrzej Przybylski
Maciej Sterliński
Artur Filipecki
Anna Pazdyga
Agnieszka Zienciuk
Maciej Kempa
Tomasz Królak
Hanna Szwed
Maria Trusz-Gluza
Włodzimierz Kargul

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