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Exercise-induced ventricular arrhythmias and risk of sudden cardiac death in patients with hypertrophic cardiomyopathy

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dc.contributor.authorGimeno Blanes, Juan Ramón
dc.contributor.authorTomé-Esteban, Maite
dc.contributor.authorLofiego, Carla
dc.contributor.authorHurtado, José
dc.contributor.authorPantazis, Antonios
dc.contributor.authorMist, Bryan
dc.contributor.authorLambiase, Pier
dc.contributor.authorMcKenna, William J.
dc.contributor.authorElliot, Perry M.
dc.contributor.departmentMedicina
dc.contributor.otherFacultad de Medicina
dc.date.accessioned2026-01-15T08:43:22Z
dc.date.available2026-01-15T08:43:22Z
dc.date.copyright© 2009 The Author
dc.date.issued2009-08-17
dc.description.abstractBackground: Non-sustained ventricular tachycardia (NSVT) during ambulatory electrocardiographic monitoring (typically occurring at rest or during sleep) is associated with an increased risk of sudden cardiac death in patients with hypertrophic cardiomyopathy. The prevalence and prognostic significance of ventricular arrhythmias during exercise is unknown. Methods and results: This was a cohort study, with prospective data collection. We studied 1380 patients, referred to a cardiomyopathy clinic in London, UK [mean age 42 years (SD 15); 62% male; mean follow-up 54 (SD 49) months]. Patients underwent two-dimensional and Doppler echocardiography, upright exercise testing, and Holter monitoring. Twenty-seven patients [mean age 40 (SD 14) years (18–64); 22 (81.5%) male] had NSVT (24) or ventricular fibrillation (VF) (3) during exercise. During exercise, 13 (54.2%) had more than one run of NSVT (maximum 5) with a mean heart rate of 221 (SD 48) b.p.m. Patients with exercise NSVT/VF had more severe hypertrophy (22.6 vs. 19.5 mm, P = 0.009) and larger left atria (47.3 vs. 43.7 mm, P = 0.03). Male gender was significantly associated with exercise NSVT/VF [22 (81.5%) vs. 832 (61.5%), P = 0.03]. Eight (29.6%) of the exercise NSVT/VF patients died or had a cardiac event (SD/ICD discharge/transplant) compared with 150 (11.1%) patients without exercise NSVT/VF, P = 0.008. Patients with NSVT/VF had a 3.73-fold increase in risk of SD/ICD discharge (HR 95% CI: 1.61–8.63, P = 0.002). Exercise NSVT alone was associated with a 2.82-fold increased risk (HR 95% CI: 1.02–7.75, P = 0.049). In multivariable analysis with other risk markers, exercise NSVT/VF (but not NSVT alone) was independently associated with an increased risk of SD/ICD [HR 3.14 (95% CI: 1.29–7.61, P = 0.01)]. Conclusion: Ventricular arrhythmia during symptom limited exercise is rare in patients with hypertrophic cardiomyopathy, but is associated with an increased risk of sudden cardiac death.
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dc.identifier.citationEuropean Heart Journal (2009) 30, 2599–2605
dc.identifier.doihttps://doi.org/10.1093/eurheartj/ehp327
dc.identifier.eissn1522-9645
dc.identifier.issn0195-668X
dc.identifier.urihttp://hdl.handle.net/10201/186990
dc.languageeng
dc.publisherOxford University Press, European Society of Cardiology
dc.relationSin financiación externa a la Universidad
dc.relation.publisherversionhttps://academic.oup.com/eurheartj/article-abstract/30/21/2599/518336?redirectedFrom=fulltext
dc.rights.accessRightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectSudden death
dc.subjectHypertrophic cardiomyopathy
dc.subjectNon-sustained ventricular tachycardia
dc.subject.odsNo relacionado con ningún objetivo de desarrollo sostenible
dc.titleExercise-induced ventricular arrhythmias and risk of sudden cardiac death in patients with hypertrophic cardiomyopathy
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
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relation.isAuthorOfPublication.latestForDiscovery4d37f6b7-66c0-4f9a-81c7-72d9bd67f2fb
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