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Titel: Effectiveness of implantable loop recorder and Holter electrocardiographic monitoring for the detection of arrhythmias in patients with peripartum cardiomyopathy
VerfasserIn: Hoevelmann, Julian
Sliwa, Karen
Briton, Olivia
Ntsekhe, Mpiko
Chin, Ashley
Viljoen, Charle
Sprache: Englisch
Titel: Clinical Research in Cardiology
Verlag/Plattform: Springer Nature
Erscheinungsjahr: 2022
Freie Schlagwörter: Peripartum cardiomyopathy
Arrhythmias
Extended electrocardiographic monitoring
Implantable loop recorder (ILR)
24 h-Holter monitoring
Sudden cardiac death
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Background Patients with peripartum cardiomyopathy (PPCM) are at increased risk of sudden cardiac death (SCD). However, the exact underlying mechanisms of SCD in PPCM remain unknown. By means of extended electrocardiographic monitoring, we aimed to systematically characterize the burden of arrhythmias occurring in patients with newly diagnosed PPCM. Methods and results Twenty-five consecutive women with PPCM were included in this single-centre, prospective clinical trial and randomised to receiving either 24 h-Holter ECG monitoring followed by implantable loop recorder implantation (ILR; REVEAL XT, Medtronic®) or 24 h-Holter ECG monitoring alone. ILR + 24 h-Holter monitoring had a higher yield of arrhythmic events compared to 24 h-Holter monitoring alone (40% vs 6.7%, p = 0.041). Non-sustained ventricular tachycardia (NSVT) occurred in four patients (16%, in three patients detected by 24 h-Holter, and multiple episodes detected by ILR in one patient). One patient deceased from third-degree AV block with an escape rhythm that failed. All arrhythmic events occurred in patients with a severely impaired LV systolic function. Conclusions We found a high prevalence of potentially life-threatening arrhythmic events in patients with newly diagnosed PPCM. These included both brady- and tachyarrhythmias. Our results highlight the importance of extended electrocardiographic monitoring, especially in those with severely impaired LV systolic function. In this regard, ILR in addition to 24 h-Holter monitoring had a higher yield of VAs as compared to 24 h-Holter monitoring alone. In settings where WCDs are not readily available, ILR monitoring should be considered in patients with severely impaired LV systolic dysfunction, especially after uneventful 24 h-Holter monitoring.
DOI der Erstveröffentlichung: 10.1007/s00392-022-02101-3
URL der Erstveröffentlichung: https://link.springer.com/article/10.1007/s00392-022-02101-3
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-375581
hdl:20.500.11880/33980
http://dx.doi.org/10.22028/D291-37558
ISSN: 1861-0692
1861-0684
Datum des Eintrags: 12-Okt-2022
Bezeichnung des in Beziehung stehenden Objekts: Supplementary Information
In Beziehung stehendes Objekt: https://static-content.springer.com/esm/art%3A10.1007%2Fs00392-022-02101-3/MediaObjects/392_2022_2101_MOESM1_ESM.docx
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Innere Medizin
Professur: M - Keiner Professur zugeordnet
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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