Istituto Auxologico Italiano, IRCCS, Department of Cardiology, Piazzale Brescia 20, 20149 Milan, Italy.
Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK.
Int J Environ Res Public Health. 2023 Feb 7;20(4):2872. doi: 10.3390/ijerph20042872.
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiac disease associated with an increased risk of life-threatening arrhythmias. The aim of the present study was to evaluate the association of ventricular arrhythmias (VA) with circadian and seasonal variation in ARVC. One hundred two ARVC patients with an implantable cardioverter defibrillator (ICD) were enrolled in the study. Arrhythmic events included (a) any initial ventricular tachycardia (VT) or fibrillation (VF) prompting ICD implantation, (b) any VT or non-sustained VT (NSVT) recorded by the ICD, and (c) appropriate ICD shocks/therapy. Differences in the annual incidence of events across seasons (winter, spring, summer, autumn) and period of the day (night, morning, afternoon, evening) were assessed both for all cardiac events and major arrhythmic events. In total, 67 events prior to implantation and 263 ICD events were recorded. These included 135 major (58 ICD therapies, 57 self-terminating VT, 20 sustained VT) and 148 minor (NSVT) events. A significant increase in the frequency of events was observed in the afternoon versus in the nights and mornings ( = 0.016). The lowest number of events was registered in the summer, with a peak in the winter ( < 0.001). Results were also confirmed when excluding NSVT. Arrhythmic events in ARVC follow a seasonal variation and a circadian rhythm. They are more prevalent in the late afternoon, the most active period of the day, and in the winter, supporting the role of physical activity and inflammation as triggers of events.
致心律失常性右室心肌病（ARVC）是一种遗传性心脏病，与危及生命的心律失常风险增加有关。本研究旨在评估 ARVC 中室性心律失常（VA）与昼夜和季节性变化的关系。本研究共纳入 102 例植入式心脏复律除颤器（ICD）的 ARVC 患者。心律失常事件包括：（a）任何初始室性心动过速（VT）或纤维性颤动（VF）促使 ICD 植入；（b）ICD 记录的任何 VT 或非持续性 VT（NSVT）；（c）ICD 电击/治疗。评估了所有心脏事件和主要心律失常事件的年度事件发生率在季节（冬季、春季、夏季、秋季）和一天中的时段（夜间、早晨、下午、晚上）的差异。共记录到植入前 67 次事件和 263 次 ICD 事件。这些事件包括 135 次重大事件（58 次 ICD 治疗、57 次自行终止的 VT、20 次持续性 VT）和 148 次轻微事件（NSVT）。与夜间和早晨相比，下午的事件频率明显增加（=0.016）。夏季记录到的事件数量最少，冬季达到峰值（<0.001）。排除 NSVT 后，结果仍然得到证实。ARVC 的心律失常事件遵循季节性和昼夜节律变化。它们在下午最活跃的时段更为常见，在冬季更为高发，支持体力活动和炎症作为事件触发因素的作用。
