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Predictors and prognostic impact of ventricular tachyarrhythmias in heart failure with mildly reduced ejection fraction

https://doi.org/10.1007/s00392-024-02406-5

Tobias Schupp (Mannheim)1, A. Schmitt (Mannheim)1, J. Rusnak (Heidelberg)2, M. Akin (Hannover)3, M. Reinhardt (Mannheim)1, N. Abel (Mannheim)1, J. Forner (Mannheim)1, J. Müller (Bad Krozingen)4, K. Weidner (Mannheim)1, I. Akin (Mannheim)1, M. Behnes (Mannheim)1

1Universitätsklinikum Mannheim I. Medizinische Klinik Mannheim, Deutschland; 2Universitätsklinikum Heidelberg Klinik für Innere Med. III, Kardiologie, Angiologie u. Pneumologie Heidelberg, Deutschland; 3Medizinische Hochschule Hannover Kardiologie und Angiologie Hannover, Deutschland; 4Universitäts-Herzzentrum Freiburg / Bad Krozingen Klinik für Kardiologie und Angiologie Bad Krozingen, Deutschland

 

Objective: This study aims to investigate predictors and the prognostic impact of ventricular tachyarrhythmias in heart failure with mildly reduced ejection fraction (HFmrEF).

Background: The occurrence of ventricular tachyarrhythmias represents an established risk factor of mortality in heart failure (HF). However, data concerning their prognostic impact in HFmrEF is limited.

Methods: Consecutive patients with HFmrEF were retrospectively included from 2016 to 2022 at one university medical center. The prognosis of patients with HFmrEF and different types of ventricular tachyarrhythmias (i.e., with non-sustained ventricular tachycardia (i.e., nsVT), sustained VT (i.e., sVT) and ventricular fibrillation (i.e., VF) was assessed regarding the primary endpoint of all-cause mortality at 30 months (median follow-up). Statistical analyses included logistic regression, Kaplan-Meier and multivariable Cox proportional regression analyses.

Results: From a total of 2,184 patients hospitalized with HFmrEF, 4.4% experienced ventricular tachyarrhythmias (i.e., 2.0% nsVT, 0.7% sVT, 1.6% VF). The occurrence of nsVT was predicted by diabetes and more advanced stages of HF, whereas sVT/VF were predicted by age, acute myocardial infarction and ischemic etiology of HF. However, the presence of nsVT (25.0%; HR = 0.760; 95% CI 0.419 – 1.380; p = 0.367) and sVT/VF (28.8%; HR = 0.928; 95% CI 0.556 – 1.549; p = 0.776) was not associated with a higher risk of 30-month all-cause mortality compared to patients with HFmrEF without ventricular tachyarrhythmias (31.5%).

Conclusion: The rates of ventricular tachyarrhythmias were rather low in patients with HFmrEF and not associated with all-cause mortality.

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