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Outcome of patients with early repolarization pattern and syncope

医学 晕厥(音系) 植入式线圈记录器 内科学 心脏病学 室上性心动过速 良性早期复极 心源性猝死 心电图 室性心动过速 室上性心律失常 复极 入射(几何) 心动过速 心肌梗塞 心房颤动 ST段 电生理学 物理 光学
作者
Tsukasa Kamakura,Jean‐Baptiste Gourraud,Nicolas Clémenty,Philippe Maury,Jacques Mansourati,Vincent Algalarrondo,Antoine Da Costa,Jean‐Luc Pasquié,Philippe Mabo,Pascal Chavernac,Gabriel Laurent,Pascal Defaye,Julien Laborderie,Antoine Leenhardt,Francisco Marı́n,Jean‐Claude Deharo,C. Giraudeau,A Quentin,Laurence Jesel,Aurélie Thollet,Romain Tixier,Nicolas Derval,Michel Haı̈ssaguerre,Vincent Probst,Frédéric Sacher
出处
期刊:Heart Rhythm [Elsevier BV]
卷期号:19 (8): 1306-1314 被引量:3
标识
DOI:10.1016/j.hrthm.2022.03.1233
摘要

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.
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