BACKGROUND: While the guidelines acknowledge the anticipated benefits of using an implantable cardioverter defibrillator (ICD) in individuals with catecholaminergic polymorphic ventricular tachycardia (CPVT). However, the potential adverse effects have received less attention.
METHODS: To address this issue comprehensively, we will explore various databases such as the Cochrane Library, Web of Science, EMBASE and PubMed. Our study will include CPVT patients, both with and without ICD implantation. Two researchers will evaluate the eligible studies independently and gather pertinent data. The quality of the studies included will be assessed using either the Newcastle-Ottawa Scale or the Cochrane Risk of Bias Tool. Data analysis will be conducted using RevMan.
BACKGROUND: Because this research depends exclusively on existing studies, obtaining patient informed consent and ethics approval is unnecessary. The results of this meta-analysis will be shared at conferences or in peer-reviewed journals.
UNASSIGNED: CRD42022370824.

In this systematic review and meta-analysis, we aim to evaluate the efficacy and safety of catheter ablation as the first-line treatment of ventricular tachycardia (VT) in patients with structural heart disease (SHD) and preserved left ventricular ejection fraction (LVEF). Patients with SHD are particularly susceptible to VT, a condition that increases the risk of sudden cardiac death (SCD). Implantable cardioverter-defibrillators (ICDs) can terminate VT and prevent SCD but do not prevent VT recurrence. The efficacy and safety of CA as a first-line treatment in SHD patients with preserved LVEF remain unclear. We searched PubMed/Medline, EMBASE, Web of Science, and Cochrane CENTRAL for studies reporting the outcomes of CA therapy in patients with VT and preserved LVEF, published up to January 19, 2023. The primary outcome was the incidence of SCD following catheter ablation as the first-line treatment of VT in patients with SHD and preserved LVEF. Secondary outcomes included all-cause mortality, VT recurrence, procedural complications, CA success rate, and ICD implantation after catheter ablation. We included seven studies in the meta-analysis, encompassing a total of 920 patients. The pooled success rate of catheter ablation was 84.6% (95% CI 67.2-93.6). Complications occurred in 6.4% (95% CI 4.0-9.9) of patients, and 13.9% (95% CI 10.1-18.8) required ICD implantation after ablation. VT recurrence was observed in 23.2% (95% CI 14.8-34.6) of patients, while the rate of sudden cardiac death (SCD) was 3.1% (95% CI 1.7-5.6). The overall prevalence of all-cause mortality in this population was 5% (95% CI 1.8-13). CA appears promising as a first-line VT treatment in patients with SHD and preserved LVEF, especially for monomorphic hemodynamically tolerated VT. However, due to the lack of direct comparisons with ICDs and anti-arrhythmic drugs, further research is needed to confirm these findings.

BACKGROUND: Although there are evolving techniques and technologies for treating ventricular tachycardia (VT), the current landscape of clinical trials for managing VT remains understudied.
OBJECTIVE: The objective of this study was to provide a systematic characterisation of the interventional management of VT through an analysis of the ClinicalTrials.gov, clinicaltrialsregister.eu, anzctr.org.au and chictr.org.cn databases.
METHODS: We queried all phase II to IV interventional trials registered up to November 2023 that enrolled patients with VT. Published, completed but unpublished, terminated, or ongoing trials were included for final analysis.
RESULTS: Of the 698 registered studies, 135 were related to VT, with 123 trials included in the final analysis. Among these trials, 25 (20%) have been published, enrolling a median of 35 patients (interquartile range [IQR] 20-132) over a median of 43 months (IQR 19-62). Out of the published trials, 14 (56%) were randomised, and 12 (48%) focused on catheter ablation. Twenty-two (18%) have been completed but remain unpublished, even after a median of 36 months (IQR 15-60). Furthermore, 27 (22%) trials were terminated or withdrawn, with the most common cause being poor enrolment. Currently, 49 (40%) trials are ongoing and novel non-ablative technologies, such as radioablation and autonomic modulation, account for 35% and 8% of ongoing trials, respectively.
CONCLUSIONS: Our analysis revealed that many registered trials remain unpublished or incomplete, and randomised controlled trial evidence is limited to only a few studies. Furthermore, many ongoing trials are focused on non-catheter ablation-based strategies. Therefore, larger pragmatic trials are needed to create stronger evidence in the future.

BACKGROUND: Risk stratification for patients with non-ischemic cardiomyopathy (NICM) remains challenging as previous studies predicting life-threatening ventricular arrhythmia (LTVA) events were conducted before the establishment of the current standard treatment. We investigated the prognostic value of non-sustained ventricular tachycardia (NSVT) in NICM patients among recent studies.
METHODS: MEDLINE, Embase were searched from January 2000 to October 2023. The risk of NSVT on LTVA and mortality was assessed using a random-effects model for patients with NICM. A meta-regression analysis was employed to identify sources of heterogeneity. The systematic review and meta-analysis were carried out according to the PRISMA guidelines.
RESULTS: A total of 18 studies were identified, including 5238 pooled participants. Meta-analysis demonstrated that the presence of NSVT was considered a significant prognostic indicator for LTVA events [hazard ratio (HR): 2.90; 95 % CI; 2.31-3.64] with low heterogeneity (I2: 19 %) and for mortality (HR; 2.28; 95%CI; 1.26-4.13) with high heterogeneity (I2: 69 %). The prognostic value of NSVT for LTVA was not affected by either ejection fraction or medications at baseline.
CONCLUSIONS: NSVT remained an important predictor of LTVA events even in patients receiving healthcare in contemporary eras. Detection of NSVT helps us to identify the high-risk patients with NICM.

Historically, patients with myocarditis were considered for implantable cardioverter defibrillator (ICD) utilization only in the chronic phase of the disease following the development of persistent cardiomyopathy refractory to medical therapy or occurrence of a major ventricular arrhythmic event. However, recent literature has indicated that ventricular arrhythmias are frequently reported even in the acute phase of the disease, challenging the long-standing perception that this disease process was largely reversible. Given this changing environment of information, the latest US and European guidelines were recently updated in 2022 to now consider ICD implantation during the acute phase which has significantly increased the number of individuals eligible for these devices. Additionally, several studies with small subgroups of patients have demonstrated a possible benefit of wearable cardioverter defibrillators (WCDs) in this patient demographic. Assuming that larger studies confirm their utility, it is possible that WCDs can assist in detection of ventricular arrhythmias and selection of high-risk candidates for ICD implantation, while providing temporary protection for a small percentage of patients before the development of a major arrhythmic event. This review ultimately serves as a comprehensive review of the most recent guidelines for defibrillator use in acute and chronic myocarditis. OPINION STATEMENT: The latest US and European guidelines support ICD use for myocarditis patients following the development of persistent cardiomyopathy refractory to medical therapy or occurrence of a major ventricular arrhythmic event. Previously, patients in the acute phase were excluded from ICD utilization even after experiencing malignant ventricular tachycardia or ventricular fibrillation due to the long-standing perception that this disease process was largely reversible. However, recent literature has indicated that ventricular arrhythmias are frequently reported even in the acute phase of the disease. Additionally, we found that the myocardial damage that is inflicted persists many years after the initial episode. Given this changing environment of information, guidelines were recently updated in 2022 to now consider ICD implantation during the acute phase which has significantly increased the number of individuals eligible for these devices. We support possible ICD utilization for secondary prevention during the acute phase of myocarditis given the elevated risk of arrhythmia recurrence and the fact that any ventricular arrhythmia can induce sudden cardiac death. Future prospective studies are needed to assess which patients may benefit most from early ICD implantation. WCDs have improved survival in patient populations at high-risk for sudden cardiac death who are not candidates for ICD implantation. After analyzing several recent studies with small subgroups of patients, WCDs appear to demonstrate similar efficacy for myocarditis patients as well. Assuming that larger studies confirm their utility, we believe that WCDs can assist in detection of ventricular arrhythmias and selection of high-risk candidates for ICD implantation. Furthermore, WCDs have the additional benefit of acting as primary prevention by providing temporary protection for a small percentage of myocarditis patients before they develop a major arrhythmic event.

Heart rhythm disorders are one of the most common complications of coronavirus infection. Heart rhythm disorders can develop in 6-17% of hospitalized patients, and in convalescents, COVID-19 can manifest itself up to 12 months after the completion of the acute phase of the disease. Among the mechanisms for the development of cardiac arrhythmias, there are a direct cytopathic effect of SARS-CoV-2 on the myocardium, systemic inflammatory response syndrome, electrolyte imbalance, hypoxia, the use of antibacterial, antimalarial and antiviral drugs, exudative pericarditis, autonomic dysfunction. The main COVID-19-mediated heart rhythm disorders are sinus tachycardia and bradycardia, atrial fibrillation, ventricular tachycardia, long QT syndrome. Despite a significant amount of research, the literature data on the prevalence of certain types of cardiac arrhythmias (especially in COVID-19 convalescents), as well as methods for their correction, are somewhat contradictory and need to be clarified. Taking into account the impact of arrhythmia on the quality of life and mortality, active monitoring of convalescents of coronavirus infection, identification and development of approaches to the treatment of heart rhythm disorders in patients who have had COVID-19, seem to be relevant and promising areas in modern cardiology.
Нарушения ритма сердца (НРС) являются одними из наиболее распространенных осложнений коронавирусной инфекции. НРС могут развиваться у 6–17% госпитализированных больных, а у реконвалесцентов COVID-19 способны проявляться и через 12 мес по завершении острой фазы заболевания. Среди механизмов развития НРС выделяют прямое цитопатическое действие SARS-CoV-2 на миокард, синдром системной воспалительной реакции, нарушение электролитного баланса, гипоксию, прием антибактериальных, противомалярийных и противовирусных препаратов, экссудативный перикардит, вегетативную дисфункцию. Основные COVID-19-опосредованные НРС представлены синусовой тахикардией и брадикардией, фибрилляцией предсердий, желудочковой тахикардией, синдромом удлинения QT. Несмотря на значительный объем исследований, литературные данные относительно распространенности тех или иных разновидностей НРС (особенно у реконвалесцентов COVID-19), а также методов их коррекции несколько противоречивы и нуждаются в уточнении. Учитывая влияние аритмии на качество жизни и смертность, активное наблюдение за реконвалесцентами коронавирусной инфекции, выявление и разработка подходов к терапии НРС у лиц, перенесших COVID-19, представляются актуальными и перспективными направлениями в современной кардиологии.

暂无摘要。

Electronic gaming has recently been reported as a precipitant of life-threatening cardiac arrhythmia in susceptible individuals.
The purpose of this study was to describe the population at risk, the nature of cardiac events, and the type of game linked to cardiac arrhythmia associated with electronic gaming.
A multisite international case series of suspected or proven cardiac arrhythmia during electronic gaming in children and a systematic review of the literature were performed.
Twenty-two patients (18 in the case series and 4 via systematic review; aged 7-16 years; 19 males [86%]) were identified as having experienced suspected or proven ventricular arrhythmia during electronic gaming; 6 (27%) had experienced cardiac arrest, and 4 (18%) died suddenly. A proarrhythmic cardiac diagnosis was known in 7 (31%) patients before their gaming event and was established afterward in 12 (54%). Ten patients (45%) had catecholaminergic polymorphic ventricular tachycardia, 4 (18%) had long QT syndrome, 2 (9%) were post-congenital cardiac surgery, 2 (9%) had \"idiopathic\" ventricular fibrillation, and 1 (after Kawasaki disease) had coronary ischemia. In 3 patients (14%), including 2 who died, the diagnosis remains unknown. In 13 (59%) patients for whom the electronic game details were known, 8 (62%) were war games.
Electronic gaming can precipitate lethal cardiac arrhythmias in susceptible children. The incidence appears to be low, but syncope in this setting should be investigated thoroughly. In children with proarrhythmic cardiac conditions, electronic war games in particular are a potent arrhythmic trigger.

While Brugada syndrome (BrS) is well described in adults and older children, presentation of BrS within the first 12 months of life is rare and therefore poorly characterized. We report a 7-year-old male with a malignant BrS phenotype with onset at 8 months of age, leading to multiple ventricular tachycardia (VT) and ventricular fibrillation (VF) related cardiac arrests and ultimately his death. The report is supplemented by a comprehensive review of existing literature on infantile-onset BrS and unique features in this population are discussed.

There are marked variations in the incidence of sudden cardiac death (SCD) and in the substrates for ventricular arrhythmias (VAs) across the gamut of congenital heart defects. In this 2-part review, patients with higher-risk forms of congenital heart disease (CHD) were conceptually categorized into those with discrete anatomic isthmuses for macro-reentrant ventricular tachycardia (VT) (Group A) and those with more diffuse or less well-defined substrates (Group B) that include patchy or extensive myocardial fibrosis. The latter category encompasses CHD lesions such as Ebstein anomaly, transposition of the great arteries with a systemic right ventricle (RV), and congenital aortic stenosis. For Group B patients, polymorphic VT and ventricular fibrillation account for a higher proportion of VA. The prognostic value of programmed ventricular stimulation is less well established, and catheter ablation plays a less prominent role. As cardiomyopathies evolve over time, pathophysiological mechanisms for VA among Groups A and B become increasingly blurred.