- \(\bf Background:\) Arrhythmia and sudden cardiac death (SCD) are known complications of acute viral myocarditis, regardless of ejection fraction (EF) at presentation. Whether such complications confer long-term risk is unknown, especially in those who present with preserved left ventricular (LV) function. No guidelines exist to the long-term reduction of arrhythmic death in such patients.
\(\bf Method:\) In this retrospective study, we analyzed the long-term results of implantable cardioverter defibrillator (ICD) treatment in patients after an acute phase of myocarditis with life-threatening arrhythmia.
\(\bf Results:\) We identified 51 patients who had ICDs implanted following life-threatening arrhythmia presentation of confirmed acute viral myocarditis, despite preserved LVEF. Overall, 72.5% of patients had a clinical history of chest pain and viral infection with fever. Viral myocarditis was confirmed by cardiac magnetic resonance imaging (all had late enhancement) plus endomyocardial biopsies (most frequent were Epstein-Barr virus 29.4%, adenovirus 17.6%, and Coxsackie 17.6%), and 88.2% were discharged on anti-arrhythmic drugs. Overall, 12 patients (23.5%) required ICD intervention within the first 3 months, a further 7 patients (37.3% overall) between 3 and 12 months, and a further 12 patients (60.8% overall) until 58 months. During the follow-up, 3 of 51 patients (5.9%) died—deaths were due to cardiac events (\(\it n\) = 1), fatal infection (\(\it n\) = 1), and car accidents (\(\it n\) = 1). Of the 31 patients who had ventricular tachycardias after the acute phase of myocarditis, 11 needed radiofrequency ablation due to a high number of events or electrical storm. No baseline variables were identified that would serve as a basis for risk stratification.
\(\bf Conclusion:\) Malignant arrhythmic events due to viral myocarditis are potential predictors of future SCD in patients not only with a reduced but also with a preserved EF.
MetadatenAuthor: | Benjamin SaskoGND, Daniel PatschanGND, Peter NordbeckGND, Lea SeidlmayerGND, Henrike AndresenGND, Monique JänschGND, Peter BramlageORCiDGND, Oliver RitterGND, Nikolaos PagonasGND |
---|
URN: | urn:nbn:de:hbz:294-93467 |
---|
DOI: | https://doi.org/10.1159/000511120 |
---|
Parent Title (English): | Cardiology |
---|
Publisher: | Karger |
---|
Place of publication: | Basel |
---|
Document Type: | Article |
---|
Language: | English |
---|
Date of Publication (online): | 2022/10/14 |
---|
Date of first Publication: | 2021/02/05 |
---|
Publishing Institution: | Ruhr-Universität Bochum, Universitätsbibliothek |
---|
Tag: | Arrhythmia; Implantable cardioverter defibrillator; Preserved ejection fraction; Sudden cardiac death |
---|
Volume: | 146 |
---|
Issue: | 2 |
---|
First Page: | 213 |
---|
Last Page: | 221 |
---|
Note: | Dieser Beitrag ist aufgrund einer konsortialen Lizenz frei zugänglich. |
---|
Institutes/Facilities: | Marienhospital Herne, Medizinische Klinik I |
---|
Dewey Decimal Classification: | Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit |
---|
open_access (DINI-Set): | open_access |
---|
Licence (German): | Konsortiale Lizenz |
---|