Outcome of patients with early repolarization pattern and syncope.

Arrhythmias, Cardiac / complications Death, Sudden, Cardiac / epidemiology Electrocardiography Electrocardiography, Ambulatory Humans Syncope / diagnosis
Early repolarization Implantable loop recorder J-wave Syncope Ventricular fibrillation

Journal

Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317

Informations de publication

Date de publication:
08 2022
Historique:
received: 10 02 2022
revised: 30 03 2022
accepted: 30 03 2022
pubmed: 9 4 2022
medline: 27 7 2022
entrez: 8 4 2022
Statut: ppublish

Résumé

Syncope in patients with an early repolarization (ER) pattern presents a challenge for clinicians as it has been identified as an indicator of a higher risk of life-threatening ventricular arrhythmias (VAs). This study aimed to analyze the outcome of patients with an ER pattern and syncope and to evaluate the factors predictive of VAs. Over a period of 5 years, we enrolled 143 patients with an ER pattern and syncope in a multicenter prospective registry. After the initial examinations, 97 patients (67.8%) were implanted with a device allowing electrocardiogram monitoring, including 84 (58.7%) with an implantable loop recorder. During a mean follow-up period of 68 ± 34 months, we documented 16 arrhythmias presumably responsible for syncope (5 VAs, 10 bradycardias, and 1 supraventricular tachycardia). Additionally, recurrent syncope not associated with electrocardiogram documentation occurred in 16 patients (11.2%). The cause of syncope was identified in 23 of 97 patients with a monitoring device (23.8%). The 5-year incidence of VAs and arrhythmic events presumably responsible for syncope was 4.9% and 11.0%, respectively. Patients who developed VAs showed no prodromes or specific triggers at the time of syncope. Neither the presence of a family history of sudden cardiac death nor the previously reported high-risk electrocardiographic parameters differed between patients with and without VAs. VAs occurred in 4.9% of patients with an ER pattern and syncope. Device implantation based on detailed history taking seems to be a reasonable strategy. Previously reported high-risk electrocardiographic patterns did not identify patients with VAs.

Sections du résumé

BACKGROUND
Syncope in patients with an early repolarization (ER) pattern presents a challenge for clinicians as it has been identified as an indicator of a higher risk of life-threatening ventricular arrhythmias (VAs).
OBJECTIVES
This study aimed to analyze the outcome of patients with an ER pattern and syncope and to evaluate the factors predictive of VAs.
METHODS
Over a period of 5 years, we enrolled 143 patients with an ER pattern and syncope in a multicenter prospective registry.
RESULTS
After the initial examinations, 97 patients (67.8%) were implanted with a device allowing electrocardiogram monitoring, including 84 (58.7%) with an implantable loop recorder. During a mean follow-up period of 68 ± 34 months, we documented 16 arrhythmias presumably responsible for syncope (5 VAs, 10 bradycardias, and 1 supraventricular tachycardia). Additionally, recurrent syncope not associated with electrocardiogram documentation occurred in 16 patients (11.2%). The cause of syncope was identified in 23 of 97 patients with a monitoring device (23.8%). The 5-year incidence of VAs and arrhythmic events presumably responsible for syncope was 4.9% and 11.0%, respectively. Patients who developed VAs showed no prodromes or specific triggers at the time of syncope. Neither the presence of a family history of sudden cardiac death nor the previously reported high-risk electrocardiographic parameters differed between patients with and without VAs.
CONCLUSION
VAs occurred in 4.9% of patients with an ER pattern and syncope. Device implantation based on detailed history taking seems to be a reasonable strategy. Previously reported high-risk electrocardiographic patterns did not identify patients with VAs.

Identifiants

DOI: 10.1016/j.hrthm.2022.03.1233 PMID: 35395407
pubmed: 35395407
pii: S1547-5271(22)01877-X
doi: 10.1016/j.hrthm.2022.03.1233
pii:
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1306-1314

Informations de copyright

Copyright © 2022 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Auteurs

Tsukasa Kamakura (T)

Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.

Jean-Baptiste Gourraud (JB)

Department of Cardiology, National Reference Centre for Inherited Cardiac Arrhythmia, L'institut du thorax, INSERM, CNRS, University of Nantes, Nantes University Hospital, Nantes, France.

Nicolas Clementy (N)

Department of Cardiology, University Hospital of Tours, Tours, France.

Philippe Maury (P)

Department of Cardiology, University Hospital Rangueil, Toulouse, France.

Jacques Mansourati (J)

Department of Cardiology, University Hospital of Brest, Brest, France.

Didier Klug (D)

Department of Electrophysiology, Lille University Hospital, Lille, France.

Antoine Da Costa (A)

Department of Cardiology, Saint-Etienne University Hospital, Saint-Etienne, France.

Jean-Luc Pasquie (JL)

Department of Cardiology and PhyMedExp, Université Montpellier, INSERM, CNRS, CHRU Montpellier University Hospital, Montpellier, France.

Philippe Mabo (P)

Department of Cardiology, Rennes University Hospital, Rennes, France.

Pascal Chavernac (P)

Department of Cardiology, Centre Hospitalier de Castres, Castres, France.

Gabriel Laurent (G)

Department of Cardiology, Dijon University Hospital, Dijon, France.

Pascal Defaye (P)

Department of Cardiology, Grenoble University Hospital, Grenoble, France.

Julien Laborderie (J)

Department of Cardiology, Clinique de Bayonne, Bayonne, France.

Antoine Leenhardt (A)

Department of Cardiology, Hospital Bichat, AP-HP, Paris, France.

Nicolas Sadoul (N)

Department of Cardiology, Nancy University Hospital, Nancy, France.

Jean-Claude Deharo (JC)

Department of Cardiology, Hopital La Timone, AP-HM, Marseille, France.

Cédric Giraudeau (C)

Department of Cardiology, Cardioreliance, Orléans, France.

Anne Quentin (A)

Department of Cardiology, Centre Hospitalier de Saint Brieuc, Saint Brieuc, France.

Laurence Jesel (L)

Department of Cardiology, Strasbourg University Hospital, Strasbourg, France.

Aurelie Thollet (A)

Department of Cardiology, National Reference Centre for Inherited Cardiac Arrhythmia, L'institut du thorax, INSERM, CNRS, University of Nantes, Nantes University Hospital, Nantes, France.

Romain Tixier (R)

Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.

Nicolas Derval (N)

Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.

Michel Haissaguerre (M)

Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.

Vincent Probst (V)

Department of Cardiology, National Reference Centre for Inherited Cardiac Arrhythmia, L'institut du thorax, INSERM, CNRS, University of Nantes, Nantes University Hospital, Nantes, France.

Frederic Sacher (F)

Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France. Electronic address: frederic.sacher@chu-bordeaux.fr.

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Classifications MeSH

questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Outcome of patients with early repolarization...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Mort › Mort subite › Mort subite cardiaque › Outcome of patients with early repolarization...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Électrodiagnostic › Électrocardiographie › Outcome of patients with early repolarization...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Monitorage physiologique › Surveillance électronique ambulatoire › Électrocardiographie ambulatoire › Outcome of patients with early repolarization...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Outcome of patients with early repolarization...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Perte de conscience › Syncope › Outcome of patients with early repolarization...