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Programmed Ventricu...
Programmed Ventricular Stimulation as an Additional Primary Prevention Risk Stratification Tool in Arrhythmogenic Right Ventricular Cardiomyopathy : A Multinational Study
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- Gasperetti, Alessio (author)
- Johns Hopkins Hospital,Johns Hopkins Univ Hosp, MD 21287 USA
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- Carrick, Richard T. (author)
- Johns Hopkins Hospital,Johns Hopkins Univ Hosp, MD 21287 USA
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- Costa, Sarah (author)
- University Hospital of Zurich,Univ Hosp Zurich, Switzerland
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- Compagnucci, Paolo (author)
- University Hospital Umberto I,Univ Hosp Umberto I Salesi Lancisi, Italy
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- Bosman, Laurens P. (author)
- University Medical Center Utrecht,Univ Utrecht, Netherlands
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- Chivulescu, Monica (author)
- Norwegian Radium Hospital,Natl Hosp Norway, Norway; Univ Oslo, Norway
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- Tichnell, Crystal (author)
- Johns Hopkins Hospital,Johns Hopkins Univ Hosp, MD 21287 USA
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- Murray, Brittney (author)
- Johns Hopkins Hospital,Johns Hopkins Univ Hosp, MD 21287 USA
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- Tandri, Harikrishna (author)
- Johns Hopkins Hospital,Johns Hopkins Univ Hosp, MD 21287 USA
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- Tadros, Rafik (author)
- Montreal Heart Institute,Univ Montreal, Canada; Univ Montreal, Canada
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- Rivard, Lena (author)
- Montreal Heart Institute,Univ Montreal, Canada; Univ Montreal, Canada
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- Van Den Berg, Maarten P. (author)
- University Medical Center Groningen,Univ Groningen, Netherlands
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- Zeppenfeld, Katja (author)
- Leiden University Medical Centre,Leiden Univ, Netherlands
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- Wilde, Arthur A.M. (author)
- Academic Medical Center of University of Amsterdam (AMC),Amsterdam UMC, Netherlands
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- Pompilio, Giulio (author)
- Johns Hopkins Hospital
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- Carbucicchio, Corrado (author)
- University of Milan,Centro Cardiologico Monzino,IRCCS, Italy
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- Dello Russo, Antonio (author)
- University Hospital Umberto I,Univ Hosp Umberto I Salesi Lancisi, Italy
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- Casella, Michela (author)
- University Hospital Umberto I,Univ Hosp Umberto I Salesi Lancisi, Italy
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- Svensson, Anneli (author)
- Linköpings universitet,Linköping University,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US,Univ Utrecht, Netherlands,University Medical Center Utrecht
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- Brunckhorst, Corinna B. (author)
- University Hospital of Zurich,Univ Hosp Zurich, Switzerland
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- Van Tintelen, J. Peter (author)
- University Medical Center Utrecht,Univ Utrecht, Netherlands
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- Platonov, Pyotr G. (author)
- 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
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- Haugaa, Kristina H. (author)
- Karolinska Institutet
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- Duru, Firat (author)
- University Hospital of Zurich,Univ Hosp Zurich, Switzerland
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- Te Riele, Anneline S.J.M. (author)
- University Medical Center Utrecht
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- Khairy, Paul (author)
- Montreal Heart Institute,Univ Montreal, Canada; Univ Montreal, Canada
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- Tondo, Claudio (author)
- Centro Cardiologico Monzino,IRCCS, Italy; Univ Milan, Italy
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- Calkins, Hugh (author)
- Johns Hopkins Hospital,Johns Hopkins Univ Hosp, MD 21287 USA
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- James, Cynthia A. (author)
- Johns Hopkins Hospital,Johns Hopkins Univ Hosp, MD 21287 USA
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- Saguner, Ardan M. (author)
- University Hospital of Zurich,Univ Hosp Zurich, Switzerland
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- Cadrin-Tourigny, Julia (author)
- Johns Hopkins Hospital,Univ Montreal, Canada; Univ Montreal, Canada
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(creator_code:org_t)
- Lippincott, Williams & Wilkins, 2022
- 2022
- English 10 s.
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In: Circulation. - : Lippincott, Williams & Wilkins. - 0009-7322 .- 1524-4539. ; 146:19, s. 1434-1443
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https://liu.diva-por... (primary) (Raw object)
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https://doi.org/10.1...
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Abstract
Subject headings
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- arrhythmogenic right ventricular cardiomyopathy
- defibrillator, implantable
- electrophysiological techniques, cardiac
- risk assessment
- sudden cardiac death
- arrhythmogenic right ventricular cardiomyopathy; electrophysiological techniques; cardiac; defibrillator; implantable; risk assessment; sudden cardiac death
Publication and Content Type
- art (subject category)
- ref (subject category)
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Gasperetti, Ales ...
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Carrick, Richard ...
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Costa, Sarah
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Compagnucci, Pao ...
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Bosman, Laurens ...
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Chivulescu, Moni ...
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Tichnell, Crysta ...
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Murray, Brittney
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Tandri, Harikris ...
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Tadros, Rafik
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Rivard, Lena
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Van Den Berg, Ma ...
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Zeppenfeld, Katj ...
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Wilde, Arthur A. ...
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Pompilio, Giulio
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Carbucicchio, Co ...
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Dello Russo, Ant ...
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Casella, Michela
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Svensson, Anneli
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Brunckhorst, Cor ...
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Van Tintelen, J. ...
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Platonov, Pyotr ...
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Haugaa, Kristina ...
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Duru, Firat
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Te Riele, Anneli ...
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Khairy, Paul
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Tondo, Claudio
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Calkins, Hugh
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James, Cynthia A ...
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Saguner, Ardan M ...
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Cadrin-Tourigny, ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Circulation
- By the university
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Lund University
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Linköping University
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Karolinska Institutet