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. 2018 Jul 16:6:e5312.
doi: 10.7717/peerj.5312. eCollection 2018.

Comparison of ventricular tachyarrhythmia recurrence between ischemic cardiomyopathy and dilated cardiomyopathy: a retrospective study

Chih-Yuan Fang  1   2 , Huang-Chung Chen  1   2 , Yung-Lung Chen  1   2 , Tzu-Hsien Tsai  1   2 , Kuo-Li Pan  2   3 , Yu-Sheng Lin  2   3 , Mien-Cheng Chen  1   2 , Wei-Chieh Lee  1   2
Affiliations

Comparison of ventricular tachyarrhythmia recurrence between ischemic cardiomyopathy and dilated cardiomyopathy: a retrospective study

Chih-Yuan Fang et al. PeerJ. .

Abstract

Background: The use of an implantable cardioverter-defibrillator (ICD) has been established as an effective secondary prevention strategy for ventricular tachycardia (VT)/ventricular fibrillation (VF). However, few reports discuss the difference in clinical predictors for recurrent VT/VF between patients with ischemic cardiomyopathy (ICM) and patients with dilated cardiomyopathy (DCM).

Methods: From May 2004 to December 2015, 132 consecutive patients who had ICM (n = 94) or DCM (n = 38) and had received ICD implantation for secondary prevention were enrolled in this study. All anti-tachycardia events during follow-up were validated. The clinical characteristics and echocardiographic parameters were obtained for comparison. The incidence of recurrence of VT/VF, cardiovascular mortality, all-cause mortality, the change of left ventricular ejection fraction (LVEF) and LV volume were analyzed.

Results: At a mean follow-up of 3.62 ± 2.93 years, 34 patients (36.2%) in the ICM group and 22 patients (57.9%) in the DCM group had a recurrence of VT/VF episodes (p = 0.032). The DCM group had a lower LVEF (p = 0.019), a larger LV end-diastolic volume (LVEDV) (p = 0.001), a higher prevalence of LVEDV >158 mL (p = 0.010), and a larger LV end-systolic volume (p = 0.010) than the ICM group. LVEDV >158 mL and no use of angiotensin-converting-enzyme inhibitor/angiotensin receptor blocker were independent predictors of recurrences of VT/VF in ICM patients but not in DCM patients. There were no difference in cardiovascular mortality and all-cause mortality between the ICM and DCM patients.

Conclusion: The DCM patients had a higher recurrence rate of VT/VF than did the ICM patients during long-term follow-up. An enlarged LV is an independent predictor of the recurrence of VT/VF in ICM patients receiving ICD for secondary prevention.

Keywords: Dilated cardiomyopathy; Implantable cardioverter-defibrillator; Ischemic cardiomyopathy; Ventricular tachyarrhythmia.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. Kaplan–Meier curves of 1-year, 3-year, and 5-year event free survival from recurrent ventricular tachycardia (VT)/ventricular fibrillation (VF) between ICM and DCM.
Study sites: ICM, ischemic cardiomyopathy; DCM, dilated cardiomyopathy.
Figure 2
Figure 2. Kaplan–Meier curves of 1-year, 3-year, and 5-year event free survival from recurrent ventricular tachycardia (VT)/ventricular fibrillation (VF) between ICM with LVEDV >158 mL and DCM.
Study sites: ICM, ischemic cardiomyopathy; DCM, dilated cardiomyopathy; LVEDV, left ventricular end diastolic volume.
See this image and copyright information in PMC

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