Lin Chin-Yu, Chang Shih-Lin, Chung Fa-Po, Chen Yun-Yu, Lin Yenn-Jiang, Lo Li-Wei, Hu Yu-Feng, Tuan Ta-Chuan, Chao Tze-Fan, Liao Jo-Nan, Chang Yao-Ting, Lin Chung-Hsing, Allamsetty Suresh, Walia Rohit, Te Abigail Louise D, Yamada Shinya, Chiang Shuo-Ju, Tsao Hsuan-Ming, Chen Shih-Ann
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
PLoS One. 2016 Aug 22;11(8):e0160181. doi: 10.1371/journal.pone.0160181. eCollection 2016.
The impact of non-sustained ventricular tachycardia (NSVT) on the risk of thromboembolic event and clinical outcomes in patients without structural heart disease remains undetermined. This study aimed to evaluate the association between NSVT and clinical outcomes.
The study population of 5903 patients was culled from the "Registry of 24-hour ECG monitoring at Taipei Veterans General Hospital" (REMOTE database) between January 1, 2002 and December 31, 2004. Of that total, we enrolled 3767 patients without sustained ventricular tachycardia, structural heart disease, and permanent pacemaker. For purposes of this study, NSVT was defined as 3 or more consecutive beats arising below the atrioventricular node with an RR interval of <600 ms (>100 beats/min) and lasting < 30 seconds.
There were 776 deaths, 2042 hospitalizations for any reason, 638 cardiovascular (CV)-related hospitalizations, 350 ischemic strokes, 409 transient ischemic accident (TIA), 368 new-onset heart failure (HF), and 260 new-onset atrial fibrillation (AF) with a mean follow-up duration of 10 ± 1 years. In multivariate analysis, the presence of NSVT was independently associated with death (hazard ratio [HR]: 1.362, 95% confidence interval [CI]: 1.071-1.731), CV hospitalization (HR: 1.527, 95% CI: 1.171-1.992), ischemic stroke (HR: 1.436, 95% CI: 1.014-2.032), TIA (HR 1.483, 95% CI: 1.069-2.057), and new-onset HF (HR: 1.716, 95% CI: 1.243-2.368). There was no significant association between the presence of NSVT and all-cause hospitalization or new-onset AF.
In patients without structural heart disease, presence of NSVT on 24-hour monitoring was independently associated with death, CV hospitalization, ischemic stroke, TIA, and new onset heart failure.
非持续性室性心动过速（NSVT）对无结构性心脏病患者发生血栓栓塞事件风险及临床结局的影响尚不确定。本研究旨在评估NSVT与临床结局之间的关联。
研究人群来自2002年1月1日至2004年12月31日期间台北荣民总医院的“24小时心电图监测登记处”（REMOTE数据库）中的5903例患者。其中，我们纳入了3767例无持续性室性心动过速、结构性心脏病及永久性起搏器的患者。在本研究中，NSVT被定义为房室结以下连续3次或更多次搏动，RR间期<600毫秒（>100次/分钟），持续时间<30秒。
共有776例死亡、2042例因任何原因住院、638例心血管（CV）相关住院、350例缺血性卒中、409例短暂性脑缺血发作（TIA）、368例新发心力衰竭（HF）以及260例新发心房颤动（AF），平均随访时间为10±1年。在多变量分析中，NSVT的存在与死亡（风险比[HR]：1.362，95%置信区间[CI]：1.071 - 1.731）、CV住院（HR：1.527，95% CI：1.171 - 1.992）、缺血性卒中（HR：1.436，95% CI：1.014 - 2.032）、TIA（HR 1.483，95% CI：1.069 - 2.057）以及新发HF（HR：1.716，95% CI：1.243 - 2.368）独立相关。NSVT的存在与全因住院或新发AF之间无显著关联。
在无结构性心脏病的患者中，24小时监测发现NSVT与死亡、CV住院、缺血性卒中、TIA及新发心力衰竭独立相关。
