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  • Gasperetti, AlessioJohns Hopkins Hospital,Johns Hopkins Univ Hosp, MD 21287 USA (author)

Programmed Ventricular Stimulation as an Additional Primary Prevention Risk Stratification Tool in Arrhythmogenic Right Ventricular Cardiomyopathy : A Multinational Study

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • Lippincott, Williams & Wilkins,2022
  • 10 s.

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  • LIBRIS-ID:oai:lup.lub.lu.se:6b70a1f7-405a-409a-aa23-c5d661aa008b
  • https://lup.lub.lu.se/record/6b70a1f7-405a-409a-aa23-c5d661aa008bURI
  • https://doi.org/10.1161/CIRCULATIONAHA.122.060866DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-190105URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:151124018URI

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  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Funding Agencies|Leonie-Wild Foundation; Leyla Erkan Family Fund for ARVD Research; Hugh Calkins, Marvin H. Weiner, and Jacqueline J. Bernstein Cardiac Arrhythmia Center; Marvin H. Weiner, and Jacqueline J. Bernstein Cardiac Arrhythmia Center; Dr. Francis P. Chiramonte Private Foundation; Dr. Satish, Rupal, and Robin Shah ARVD Fund at Johns Hopkins; Bogle Foundation; Healing Hearts Foundation; Campanella Family; Patrick J. Harrison Family; Peter French Memorial Foundation; Wilmerding Endowments; Fondation Leducq; National Center for Advancing Translational Sciences [UL1TR001079]; Philippa and Marvin Carsley cardiology research chair; Montreal Heart Institute Foundation; Georg und Bertha Schwyzer-Winiker Foundation; Baugarten Foundation; Swiss Heart Foundation [FF17019, FF21073]; Swiss National Science Foundation [160327]; Swedish Heart Lung Foundation [20200674]; Swedish state under the Avtal om lakarutbildning och forsknin (ALF)-agreement; Netherlands Cardiovascular Research Initiative; Dutch Heart Foundation [CVON201512/2018-30]
  • Background: A novel risk calculator based on clinical characteristics and noninvasive tests that predicts the onset of clinical sustained ventricular arrhythmias (VA) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) has been proposed and validated by recent studies. It remains unknown whether programmed ventricular stimulation (PVS) provides additional prognostic value. Methods: All patients with a definite ARVC diagnosis, no history of sustained VAs at diagnosis, and PVS performed at baseline were extracted from 6 international ARVC registries. The calculator-predicted risk for sustained VA (sustained or implantable cardioverter defibrillator treated ventricular tachycardia [VT] or fibrillation, [aborted] sudden cardiac arrest) was assessed in all patients. Independent and combined performance of the risk calculator and PVS on sustained VA were assessed during a 5-year follow-up period. Results: Two hundred eighty-eight patients (41.0±14.5 years, 55.9% male, right ventricular ejection fraction 42.5±11.1%) were enrolled. At PVS, 137 (47.6%) patients had inducible ventricular tachycardia. During a median of 5.31 [2.89-10.17] years of follow-up, 83 (60.6%) patients with a positive PVS and 37 (24.5%) with a negative PVS experienced sustained VA (P<0.001). Inducible ventricular tachycardia predicted clinical sustained VA during the 5-year follow-up and remained an independent predictor after accounting for the calculator-predicted risk (HR, 2.52 [1.58-4.02]; P<0.001). Compared with ARVC risk calculator predictions in isolation (C-statistic 0.72), addition of PVS inducibility showed improved prediction of VA events (C-statistic 0.75; log-likelihood ratio for nested models, P<0.001). PVS inducibility had a 76% [67-84] sensitivity and 68% [61-74] specificity, corresponding to log-likelihood ratios of 2.3 and 0.36 for inducible (likelihood ratio+) and noninducible (likelihood ratio-) patients, respectively. In patients with a ARVC risk calculator-predicted risk of clinical VA events <25% during 5 years (ie, low/intermediate subgroup), PVS had a 92.6% negative predictive value. Conclusions: PVS significantly improved risk stratification above and beyond the calculator-predicted risk of VA in a primary prevention cohort of patients with ARVC, mainly for patients considered to be at low and intermediate risk by the clinical risk calculator.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Carrick, Richard T.Johns Hopkins Hospital,Johns Hopkins Univ Hosp, MD 21287 USA (author)
  • Costa, SarahUniversity Hospital of Zurich,Univ Hosp Zurich, Switzerland (author)
  • Compagnucci, PaoloUniversity Hospital Umberto I,Univ Hosp Umberto I Salesi Lancisi, Italy (author)
  • Bosman, Laurens P.University Medical Center Utrecht,Univ Utrecht, Netherlands (author)
  • Chivulescu, MonicaNorwegian Radium Hospital,Natl Hosp Norway, Norway; Univ Oslo, Norway (author)
  • Tichnell, CrystalJohns Hopkins Hospital,Johns Hopkins Univ Hosp, MD 21287 USA (author)
  • Murray, BrittneyJohns Hopkins Hospital,Johns Hopkins Univ Hosp, MD 21287 USA (author)
  • Tandri, HarikrishnaJohns Hopkins Hospital,Johns Hopkins Univ Hosp, MD 21287 USA (author)
  • Tadros, RafikMontreal Heart Institute,Univ Montreal, Canada; Univ Montreal, Canada (author)
  • Rivard, LenaMontreal Heart Institute,Univ Montreal, Canada; Univ Montreal, Canada (author)
  • Van Den Berg, Maarten P.University Medical Center Groningen,Univ Groningen, Netherlands (author)
  • Zeppenfeld, KatjaLeiden University Medical Centre,Leiden Univ, Netherlands (author)
  • Wilde, Arthur A.M.Academic Medical Center of University of Amsterdam (AMC),Amsterdam UMC, Netherlands (author)
  • Pompilio, GiulioJohns Hopkins Hospital (author)
  • Carbucicchio, CorradoUniversity of Milan,Centro Cardiologico Monzino,IRCCS, Italy (author)
  • Dello Russo, AntonioUniversity Hospital Umberto I,Univ Hosp Umberto I Salesi Lancisi, Italy (author)
  • Casella, MichelaUniversity Hospital Umberto I,Univ Hosp Umberto I Salesi Lancisi, Italy (author)
  • Svensson, AnneliLinköpings universitet,Linköping University,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US,Univ Utrecht, Netherlands,University Medical Center Utrecht(Swepub:liu)annsv58 (author)
  • Brunckhorst, Corinna B.University Hospital of Zurich,Univ Hosp Zurich, Switzerland (author)
  • Van Tintelen, J. PeterUniversity Medical Center Utrecht,Univ Utrecht, Netherlands (author)
  • Platonov, Pyotr G.Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Electrocardiology Research Group - CIEL,Forskargrupper vid Lunds universitet,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,Lund Univ, Sweden(Swepub:lu)kard-ppl (author)
  • Haugaa, Kristina H.Karolinska Institutet (author)
  • Duru, FiratUniversity Hospital of Zurich,Univ Hosp Zurich, Switzerland (author)
  • Te Riele, Anneline S.J.M.University Medical Center Utrecht (author)
  • Khairy, PaulMontreal Heart Institute,Univ Montreal, Canada; Univ Montreal, Canada (author)
  • Tondo, ClaudioCentro Cardiologico Monzino,IRCCS, Italy; Univ Milan, Italy (author)
  • Calkins, HughJohns Hopkins Hospital,Johns Hopkins Univ Hosp, MD 21287 USA (author)
  • James, Cynthia A.Johns Hopkins Hospital,Johns Hopkins Univ Hosp, MD 21287 USA (author)
  • Saguner, Ardan M.University Hospital of Zurich,Univ Hosp Zurich, Switzerland (author)
  • Cadrin-Tourigny, JuliaJohns Hopkins Hospital,Univ Montreal, Canada; Univ Montreal, Canada (author)
  • Johns Hopkins HospitalJohns Hopkins Univ Hosp, MD 21287 USA (creator_code:org_t)

Related titles

  • In:Circulation: Lippincott, Williams & Wilkins146:19, s. 1434-14430009-73221524-4539

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