Journal Article

P.3. Basic Science, Sudden Death Risk Stratification and Ventricular Arrhythmias

B. Nessler, J. Nessler, M. Kitliński, D. Mroczek-Czernecka, A. Kubinyi and W. Piwowarska

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 7, issue s3, pages S52-S52
Published in print October 2005 | ISSN: 1099-5129
Published online October 2005 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1016/j.eupc.2005.08.216
P.3. Basic Science, Sudden Death Risk Stratification and Ventricular Arrhythmias

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Aim

To assess the influence of 12-month carvedilol therapy on sudden cardiac death (SCD) risk in patients (pts) with heart failure (HF).

Material

86 pts (81males) in the age of 35-70 years with chronic, symptomatic HF, treated at least for 3 month by ACE-I and diuretics, not treated by beta-blockers. CHF was in 66 pts of ischemic origin and in 20 pts – idiopathic. 30 pts (35%) were in II NYHA class and 56 pts (65%) – in III.

Methods

In all study pts the presence of SCD risk factors was assessed basically and after 12 month carvedilol therapy. The SCD risk factors, studied in this paper, were: left ventricle ejection fraction (LVEF) below 30%, left ventricular end diastolic volume (LVEDV) over 140 ml in echo assessment, the presence of complex ventricular arrhythmias, pathologic values of turbulence parameters (TO and TS) and heart rate variability (SDNN below 100 ms) in ECG Holter monitoring, the presence of late potentials and wide QRS complexes over 114 ms in signal averaged ECG, heart rate at rest (hrs) over 75/min, persistent atrial fibrillation (AF) and prolonged qtc interval over 440 ms in rest ECG.

Results

During 12-month therapy and 36 ± 8 month follow-up 5 pts died and 2 pts had heart transplantation. From 10 analyzed SCD risk factors the significant changes were found in 3. They are listed in the table below:

The average number of SCD risk factors was 5 per pt basically and decreased significantly to 4 (p=0.001) after 12-month carvedilol therapy.

Conclusion

The continuous beta adrenergic blockade decreases the SCD risk by decreasing the prevalence of SCD risk factors.

Journal Article.  0 words.  Illustrated.

Subjects: Cardiovascular Medicine

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