Poli Stefano, Facchin Domenico, Rizzetto Francesca, Rebellato Luca, Daleffe Elisabetta, Toniolo Mauro, Miconi Antonella, Altinier Alessandro, Lanera Corrado, Indrigo Stefano, Comisso Jennifer, Proclemer Alessandro
Cardiology Division, - Azienda Sanitaria Universitaria Integrata di Udine and IRCAB Foundation, P.le Santa Maria della Misericordia, 15, 33100 Udine, Italy.
Biostatistic Unit, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani, 2, 35128 Padova, Italy.
Int J Cardiol Heart Vasc. 2019 Jan 8;22:92-95. doi: 10.1016/j.ijcha.2018.12.011. eCollection 2019 Mar.
Non-sustained ventricular tachycardia (NSVT) can occur asymptomatically and can be incidentally detected in the internal records of pacemakers (PM). The clinical value of NSVT in the population of PM patients is still uncertain.Our aim was to assess the prevalence of NSVT detected by remote PM control, to describe the clinical and demographic characteristics of patients with NSVT, and to assess the prognostic significance of NSVT in terms of both overall and cardiovascular mortality.
Consecutive patients followed with PM remote interrogations from September 2010 to December 2015 were included. The transmissions pertaining to the first 12 months of remote control were analysed and the patients were divided by those presenting NSVT and those without NSVT. The two groups were compared in terms of total mortality and cardiovascular mortality based on the administrative data provided by the regional administration of the Italian National Health System.
The prevalence of NSVT in 408 patients (62% males, mean age 75.6; SD 10.6 years old) was 21% in a year. During a mean follow-up duration of 44 months, NSVT did not emerge as independently associated with overall mortality, but was associated with cardiovascular mortality in a competing risk regression model with older age, male gender, diabetes, chronic renal insufficiency, ischemic cardiomyopathy and chronic obstructive pulmonary disease.
We show that NSVT episodes recorded by remote control in a PM population are independently associated with cardiovascular mortality with possible implications for risk stratification and therapeutic options.
非持续性室性心动过速（NSVT）可无症状发生，可在起搏器（PM）的内部记录中偶然检测到。NSVT在PM患者群体中的临床价值仍不确定。我们的目的是评估通过远程PM控制检测到的NSVT的患病率，描述NSVT患者的临床和人口统计学特征，并评估NSVT在总体死亡率和心血管死亡率方面的预后意义。
纳入2010年9月至2015年12月接受PM远程问询的连续患者。分析与远程控制的前12个月相关的传输数据，并将患者分为出现NSVT的患者和未出现NSVT的患者。根据意大利国家卫生系统区域管理部门提供的行政数据，比较两组的总死亡率和心血管死亡率。
408例患者（62%为男性，平均年龄75.6岁；标准差10.6岁）中，NSVT的年患病率为21%。在平均44个月的随访期间，在一个包含年龄较大、男性、糖尿病、慢性肾功能不全、缺血性心肌病和慢性阻塞性肺疾病的竞争风险回归模型中，NSVT并非独立与总体死亡率相关，但与心血管死亡率相关。
我们表明，在PM人群中通过远程控制记录的NSVT发作与心血管死亡率独立相关，这可能对风险分层和治疗选择有影响。
