Prevalence and prognosis of ventricular tachycardia/ventricular fibrillation in patients with post-infarction left ventricular aneurysm: Analysis of 575 cases

J Electrocardiol. 2018 Jul-Aug;51(4):742-746. doi: 10.1016/j.jelectrocard.2018.03.010. Epub 2018 Mar 21.

Abstract

Background: We investigated the prevalence of ventricular tachycardia/ventricular fibrillation (VT/VF) in Post-infarction left ventricular aneurysm (PI-LVA) patients and analyze clinical outcomes in patients presenting with VT/VF.

Methods: 575 PI-LVA patients were enrolled and investigated by logistic regression analysis. Patients with VT/VF were followed up, the composite primary endpoint was cardiac death and appropriate ICD/external shocks.

Results: The incidence of sustained VT/VF was 11%. Logistical regression analysis showed male gender, enlarged LV end diastolic diameter (LVEDD) and higher NYHA class were correlated with VT/VF development. During follow up of 46 ± 15 months, 19 out of 62(31%) patients reached study end point. Multivariate Cox regression analysis revealed that enlarged LVEDD and moderate/severe mitral regurgitation (MR) were independently predictive of clinical outcome.

Conclusions: Male gender, enlarged LVEDD and higher NYHA class associated with risk of sustained VT/VF in PI-LVA patients. Among VT/VF positive patients, enlarged LVEDD and moderate/severe MR independently predicted poor clinical prognosis.

Keywords: Left ventricular aneurysm; Left ventricular end diastolic diameter; Mitral regurgitation; Ventricular tachycardia/ventricular fibrillation.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Echocardiography
  • Female
  • Heart Aneurysm / complications*
  • Heart Aneurysm / diagnostic imaging
  • Heart Aneurysm / pathology
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / pathology*
  • Humans
  • Hypertrophy, Left Ventricular / complications
  • Infarction, Middle Cerebral Artery / diagnostic imaging
  • Infarction, Middle Cerebral Artery / etiology
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Middle Aged
  • Mitral Valve Insufficiency / complications
  • Myocardial Infarction / complications*
  • Prevalence
  • Prognosis
  • Proportional Hazards Models
  • Sex Factors
  • Stroke Volume
  • Tachycardia, Ventricular / epidemiology
  • Tachycardia, Ventricular / etiology*
  • Ventricular Fibrillation / epidemiology
  • Ventricular Fibrillation / etiology*