206 Ventricular arythmias in cardiac pacing patients: monocentric study

Abstract

The new pacemaker (PM) generations featuring extended memory functions (MF) document the occurrence of arrhythmias over periods of several months. Recordings of all atrial episodes and their characteristics contribute to the efficacious treatment of these patients. However, ventricular arrhythmia (VA) characteristics and occurrences are less well-known in this population. The goal of this study was to evaluate the pertinence of MF at the ventricular level and to describe the MF-documented VAs. the study involved a continuous series of 93 pts (M 66%, aged 75 ± 10 yrs) implanted with SC or DC Kappa and EnPulse PMs (Medtronic, MN, USA) for AVB 41%, SD 55%. 497 visits were analyzed (follow-up at 7 months avg.) over a period from 2 to 81 months after implantation, and occurrences of VA validated by EGMs, defined by at least 5 QRS complexes >175/mn. The number of episodes and the duration and heart rate during the longest arrhythmia episodes were recorded. 24 pts (26%) average ages 74 ± 13 yrs of whom 78% males, showed ventricular arrhythmias in 88 visits (18%). The average number of episodes was 9 per follow-up (1–140), average duration was 4 ± 4 seconds (1–27 sec), and average rate was 214 ± 33 bpm. (174–307). The totality of the episodes were classified as non-sustained ventricular tachycardia (NSVT). The ejection fraction was 51 ± 11%. 84% showed cardiopathy: CAD (12), HCM(4) and DCM (4). Statistical analysis showed that age, pacing indication, pacing mode and cumulated percentage of pacing are not relevant factors in NSVT. VAs are observed in π of pts implanted for standard pacing indications. A major determining factor in the occurrence of NSVT is the presence of an associated cardiopathy. FMs featuring EGM recordings are a tool for reliable diagnostic and monitoring of these events. Further studies are required to evaluate the prognostic significance of these VAs.