Abstract
Background: Non-sustained ventricular tachycardia (NSVT) is an arrhythmia prevalent in both structurally normal and abnormal hearts. Methods: We conducted a single-center retrospective clinical audit of patients followed-up in a device clinic with one or more incidental NSVT episodes recorded on their device between November 2017 and August 2018 and followed up patients for outcomes until January 2019. Results: A total of 83 patients were included in the analysis with one or more episodes of NSVT on device interrogation. Those identified to have NSVT were more likely to be male (74.7%) and there was a mean of 14.2 beats per episode and a mean of 3.7 episodes for each patient. Only 24.7% of patients had electrolytes checked within 4 weeks of episode detection and 18.3% had an echocardiogram post-episode. The majority of patients (73.5%) were followed up again in the pacing clinic but had no changes in medication, or other management implemented. In terms of outcomes, 81.7% of patients had no admission to hospital, mortality, or shock during the follow-up period. Conclusions: Most patients who developed NSVT did not have an extra follow-up, medication review, or investigation. Despite this, outcomes such as admission, shock, or death were uncommon.
Highlights
Non-sustained ventricular tachycardia (NSVT) is an arrhythmia prevalent in both structurally normal and abnormal hearts [1]
Most patients who developed NSVT did not develop adverse outcomes such as VT-related admission, shock or death in the follow-up period. This is the first study to consider the management of patients after identification of incidental NSVT events; 91% of patients were followed up in routine pacing or cardiology clinic, 25% had urea and electrolytes checked post-NSVT and 18% had a post-NSVT
Patients were not randomised into a treatment group, all included patients were followed up for treatment and the results showed no differences in outcome regardless of the degree of clinic follow-up or medication rationalisation
Summary
Non-sustained ventricular tachycardia (NSVT) is an arrhythmia prevalent in both structurally normal and abnormal hearts [1]. NSVT is associated with an increased risk of mortality in patients with coronary heart disease, left ventricular hypertrophy and severe heart failure [2,3,4]. Even in structurally normal hearts, NSVT has been associated with cardiovascular hospitalisation, stroke and death [5]. Given the adverse outcomes associated with NSVT, it is important to gain better insights on this arrhythmia. There is no consensus on diagnostic criteria for this ectopic ventricular rhythm and there are several definitions in the existing literature (see Table S1) [4,6,7,8,9]. There is variation in the number of beats required to characterise NSVT; some definitions require at least
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