TY - JOUR
T1 - Ventricular tachyarrhythmia detection by implantable loop recording in patients with heart failure and preserved ejection fraction
T2 - the VIP-HF study
AU - van Veldhuisen, Dirk J.
AU - van Woerden, Gijs
AU - Gorter, Thomas M.
AU - van Empel, Vanessa P. M.
AU - Manintveld, Olivier C.
AU - Tieleman, Robert G.
AU - Maass, Alexander H.
AU - Vernooy, Kevin
AU - Westenbrink, B. Daan
AU - van Gelder, Isabelle C.
AU - Rienstra, Michiel
N1 - Funding Information:
The VIP‐HF study ( ClinicalTrials.gov identifier NCT01989299) was financially supported by an unrestricted grant from Abbott‐Netherlands to the University Medical Centre Groningen. Abbott‐Netherlands was neither involved in the conduction of the study, nor in the writing of the manuscript.
Funding Information:
The VIP-HF study (ClinicalTrials.gov identifier NCT01989299) was financially supported by an unrestricted grant from Abbott-Netherlands to the University Medical Centre Groningen. Abbott-Netherlands was neither involved in the conduction of the study, nor in the writing of the manuscript. Conflict of interest: none declared.
Publisher Copyright:
© 2020 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
PY - 2020/10
Y1 - 2020/10
N2 - Aims The primary aim of the VIP-HF study was to examine the incidence of sustained ventricular tachyarrhythmias (VTs) in heart failure (HF) with mid-range (HFmrEF) or preserved ejection fraction (HFpEF). Secondary aims were to examine the incidence of non-sustained VTs, bradyarrhythmias, HF hospitalizations and mortality. Methods and results This was an investigator-initiated, prospective, multicentre, observational study of patients with HF and left ventricular ejection fraction (LVEF) >40%. Patients underwent extensive phenotyping, after which an implantable loop recorder was implanted. We enrolled 113 of the planned 250 patients [mean age 73 +/- 8 years, 51% women, New York Heart Association class II/III 54%/46%, median N-terminal pro B-type natriuretic peptide 1367 (710-2452) pg/mL and mean LVEF 54 +/- 6%; 75% had LVEF >50%]. Eighteen percent had non-sustained VTs and 37% had atrial fibrillation on Holter monitoring. During a median follow-up of 657 (219-748) days, the primary endpoint of sustained VT was observed in one patient. The incidence of the primary endpoint was 0.6 (95% confidence interval 0.2-3.5) per 100 person-years. The incidence of the secondary endpoint of non-sustained VT was 11.5 (7.1-18.7) per 100 person-years. Five patients developed bradyarrhythmias [3.2 (1.4-7.5) per 100 person-years], three were implanted with a pacemaker. In total, 23 patients (20%) were hospitalized for HF [16.3 (10.9-24.4) per 100 person-years]. Fourteen patients (12%) died [8.7 (5.2-14.7) per 100 person-years]; 10 due to cardiovascular causes, and four sudden deaths, one with implantable loop recorder-confirmed bradyarrhythmias as terminal event, three others undetermined. Conclusion Despite the lower than expected number of included patients, the incidence of sustained VTs in HFmrEF/HFpEF was low. Clinically relevant bradyarrhythmias were more often observed than expected.
AB - Aims The primary aim of the VIP-HF study was to examine the incidence of sustained ventricular tachyarrhythmias (VTs) in heart failure (HF) with mid-range (HFmrEF) or preserved ejection fraction (HFpEF). Secondary aims were to examine the incidence of non-sustained VTs, bradyarrhythmias, HF hospitalizations and mortality. Methods and results This was an investigator-initiated, prospective, multicentre, observational study of patients with HF and left ventricular ejection fraction (LVEF) >40%. Patients underwent extensive phenotyping, after which an implantable loop recorder was implanted. We enrolled 113 of the planned 250 patients [mean age 73 +/- 8 years, 51% women, New York Heart Association class II/III 54%/46%, median N-terminal pro B-type natriuretic peptide 1367 (710-2452) pg/mL and mean LVEF 54 +/- 6%; 75% had LVEF >50%]. Eighteen percent had non-sustained VTs and 37% had atrial fibrillation on Holter monitoring. During a median follow-up of 657 (219-748) days, the primary endpoint of sustained VT was observed in one patient. The incidence of the primary endpoint was 0.6 (95% confidence interval 0.2-3.5) per 100 person-years. The incidence of the secondary endpoint of non-sustained VT was 11.5 (7.1-18.7) per 100 person-years. Five patients developed bradyarrhythmias [3.2 (1.4-7.5) per 100 person-years], three were implanted with a pacemaker. In total, 23 patients (20%) were hospitalized for HF [16.3 (10.9-24.4) per 100 person-years]. Fourteen patients (12%) died [8.7 (5.2-14.7) per 100 person-years]; 10 due to cardiovascular causes, and four sudden deaths, one with implantable loop recorder-confirmed bradyarrhythmias as terminal event, three others undetermined. Conclusion Despite the lower than expected number of included patients, the incidence of sustained VTs in HFmrEF/HFpEF was low. Clinically relevant bradyarrhythmias were more often observed than expected.
KW - Heart failure with preserved ejection fraction
KW - Heart failure with mid-range ejection fraction
KW - Ventricular tachyarrhythmias
KW - Sudden death
KW - Bradyarrhythmias
KW - SUDDEN CARDIAC DEATH
KW - CARDIOVERTER-DEFIBRILLATOR
KW - RISK STRATIFICATION
KW - ESC GUIDELINES
KW - ARRHYTHMIAS
KW - MORTALITY
KW - MODE
U2 - 10.1002/ejhf.1970
DO - 10.1002/ejhf.1970
M3 - Article
C2 - 32683763
SN - 1388-9842
VL - 22
SP - 1923
EP - 1929
JO - European journal of heart failure
JF - European journal of heart failure
IS - 10
ER -