RT-234
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Predictors of non sustained
ventricular tachycardia in patients with chronic congestive heart failure undergoing
24-hour Holter monitoring
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Claudio Fresco, Alessandro
Proclemer, Maria Cecilia Albanese, Donata Lucci*, Marco Gorini*, Aldo Pietro Maggioni*,
Anna Linda Cuzzato, Paolo Maria Fioretti, a nome dei ricercatori IN-CHF.
Istituto di Cardiologia, Azienda Ospedaliera Santa Maria della Misericordia,
Udine,
*Centro Studi ANMCO, Florence, Italy
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Introduction
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Ventricular arrhythmias are very frequently found in
patients with congestive heart failure. A number of studies have reported that 70-95% of
patients with cardiomyopathy and congestive heart failure have frequent ventricular
premature beats, and 40-80% will manifest runs of non sustained ventricular tachycardia1. A prognostic value of non sustained ventricular
tachycardia has been inconsistently shown several times, and only recently the GESICA
trial has brought substantial and convincing evidences of the magnitude of the risk of
death associated with the presence of non sustained ventricular tachycardia in heart
failure patients2. As a further point of interest, non
sustained ventricular tachycardia has been recently used as entry criteria for a trial
comparing standard antiarrhythmic treatment with implantable defibrillator3. In that study the strategy of implanting an automatic
defibrillator proved superior in terms of mortality reduction, therefore suggesting that
non sustained ventricular tachycardia should be sought more thoroughly in heart failure
patients because it might represent the first step of stratification protocol for sudden
death prevention. From the epidemiological point of view it must be stressed that all the
data available for arrhythmias and congestive heart failure come from outside Italy. It is
therefore important to know if the prevalence of NSVT in Italian patients is comparable to
what published in literature. Furthermore, it has been suggested that the prevalence of
ventricular arrhythmias might be influenced by congestive heart failure treatment1. Therefore, it might be important to know the real
prevalence of NSVT in a population of patients with congestive heart failure treated with
ACE-inhibitors, digitalis and diuretics.
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Key Words
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Pacing - congestive heart failure
non-sustained ventricualr tachycardia, sudden death, Holter ECG, Italian Network for
Congestive Heart Failure, Captopril-Digoxin trial, GESICA trial, angiotensin converting
enzyme inhibitors, V-Heft II trial, enalapril, GISSI-3, lisinopril, benazapril, CONSENSUS
trial, amiodarone, proarrhythmia, OA
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