METHODS: One thousand six hundred seventy-five patients with WCD were included in a multicenter registry from 9 European centers, with a median follow-up of 440 days (IQR 120-893). The primary study end point was the occurrence of sustained VT/VF.
RESULTS: Sustained VT was detected by WCD in 5.4% and VF in 0.9% of all patients. Of the 30.3% of patients receiving ICD implantation during follow-up, sustained VT was recorded in 9.3% and VF in 2.6%. Non-ischemic cardiomyopathy (HR 0.5, p < 0.001), and medication with angiotensin-converting enzyme inhibitors (HR 0.7, p = 0.027) and aldosterone antagonists (HR 0.7, p = 0.005) were associated with a significantly lower risk of VT/VF.
CONCLUSIONS: Patients who received WCD due to a transient increased risk of sudden cardiac death have a comparatively lower risk of VT/VF in the presence of non-ischemic cardiomyopathy. Of note, optimal medical treatment for heart failure not only results in an improvement in left ventricular ejection fraction but also in a reduction in the risk for VT/VF.
方法:来自9个欧洲中心的多中心注册表中包括了一千六百七十五名WCD患者,中位随访时间为440天(IQR120-893)。主要研究终点是持续VT/VF的发生。
结果:在所有患者中,通过WCD检测到的持续性室性心动过速为5.4%,VF为0.9%。在随访期间接受ICD植入的30.3%患者中,持续性室性心动过速为9.3%,VF为2.6%.非缺血性心肌病(HR0.5,p<0.001),血管紧张素转换酶抑制剂(HR0.7,p=0.027)和醛固酮拮抗剂(HR0.7,p=0.005)与VT/VF的风险显著降低相关.
结论:在非缺血性心肌病存在的情况下,因暂时性心源性猝死风险增加而接受WCD治疗的患者的VT/VF风险相对较低。值得注意的是,心力衰竭的最佳药物治疗不仅可以改善左心室射血分数,而且可以降低VT/VF的风险.