STUDIO DELLE TACHICARDIE VENTRICOLARI NON SOSTENUTE MEDIANTE MONITORAGGIO ELETTROCARDIOGRAFICO ESTERNO DI LUNGA DURATA IN UNA COORTE NON SELEZIONATA DI PAZIENTI AFFETTI DA CARDIOMIOPATIA IPERTROFICA
Non-sustained ventricular tachycardia (NSVT) represents an established risk marker for sudden death (SD) in patients with hypertrophic cardiomyopathy (HCM). It has been reported that combining Holter ECG and implantable cardioverter-defibrillator (ICD) monitoring, the prevalence of NSVT in high-risk HCM patients is far higher than that reported in unselected HCM patients. Moreover, long-term continuous rhythm monitoring with ICD in high-risk HCM patients showed that ICD-NSVT have distinct features as compared to Holter-NSVT, and that high-rate and long-lasting NSVT associate with life-threatening arrhythmia. Therefore, available evidence suggest that NSVT in high-risk HCM patients should not be considered in a simply binary manner, and that longer and faster NSVT affect the risk of sustained VT/VF and possibly SD.
The intrinsic limits of appropriate ICD intervention as a surrogate marker of aborted death and restriction of published observations on the prognostic value of NSVT features to high-risk patients do not presently allow to speculate on the value of NSVT characteristics to predict SD in the general population.
This research project aims to assess prevalence and characteristics of non-sustained ventricular arrhythmia in an unselected cohort of HCM patients at low or intermediate risk of sudden cardiac death by means of long-lasting external ECG loop recorders.
Prolonged rhythm monitoring with ELR may improve risk-stratification and support clinical evaluation of those patients with HCM at low or intermediate risk of SD in which the decision to implant an ICD needs to be individualized.