A SYSTEMATIC REVIEW OF THE OCCURRENCE OF PATHOLOGICAL ARRHYTHMIA IN INDIVIDUALS WHO CAME TO THE EMERGENCY ROOM WITH THE DIAGNOSIS OF CARDIAC ARRHYTHMIA

Aim: A systematic review of the occurrence of pathological arrhythmia in individuals who came to the emergency room with the diagnosis of cardiac arrhythmia. Although myocardial fibrosis is often seen in HCM, its medical importance is unknown.

Methods: In 178 HCM individuals (age 42 + 17 years; 96% normal or minimally asymptomatic), researchers investigated the incidence in addition incidence of tachyarrhythmias on 24-h ambulatory Holter electrocardiogram in relation to deferred enhancement on contrast-enhanced CMR.

Results: Individuals having DE had the higher rate of premature ventricular contractions, couplets, including non-sustained ventricular tachycardia (PVCs: 87% vs. 71%; couplets: 42% vs. 18%; NSVT: 29% vs. 5%; p 0.0002 to 0.008). PVCs (203 + 657 vs. 117 + 436), couplets (1.8 + 5 vs. 1.3 + 11), and NSVT runs (0.5 + 0.9 vs. 0.07 + 0.5) were significantly higher in DE individuals than in non-DE patient populations (each p 0.0002); DE had been an autonomous predictor of NSVT (absolute likelihood 7.4, 96% confident range 2.7 to 21.5; p 0.0002). Conversely, the degree (%) of DE in individuals presenting with and without PVCs (8.3% vs. 9.2%; p 0.94), distiches (8.6% vs. 9.6%; p 0.98), or NSVT (9.4% vs. 8.6%; p 0.36) remained comparable.

Conclusion: Myocardial fibrosis revealed by CMR has been related to the higher risk in addition occurrence of ventricular tachyarrhythmias on ambulatory Holter ECG in this large HCM population to no or only moderate signs. As either a result, contrast-enhanced CMR detects HCM individuals who are predisposed to ventricular tachyarrhythmias.

Keywords: Pathological Arrhythmia, Systematic Review, Myocardial Fibrosis, Cardiac Arrhythmia.