Device‐detected nonsustained ventricular tachycardia in adult congenital heart disease without tetralogy of fallot

Abstract

ObjectivesTo evaluate any association between non‐sustained ventricular tachycardia (NSVT) detected by intra‐cardiac device and clinical outcomes in repaired adult congenital heart disease (ACHD) without tetralogy of Fallot (TOF).BackgroundNSVT portends a higher risk of serious ventricular tachyarrhythmia in TOF. However its clinical significance when incidentally detected by implantable cardiac device is not well elucidated in non‐TOF ACHD cohort.MethodsWe performed a single center, retrospective, longitudinal follow‐up study in repaired ACHD (≥18 years) patients without TOF who hosted a pacemaker or automatic implantable cardiac defibrillator (AICD). The cohort was divided based on presence/absence of device detected NSVT. The primary end‐point was a composite of sustained ventricular tachycardia (VT), ventricular fibrillation (VF), or sudden cardiac death (SCD).ResultsOne hundred fifty eight patients (male 56.3%, median [IQR] age of 35 [28–43] years at last follow‐up] with longitudinal post‐implant follow‐up duration of 8 (5–12) years were included. NSVT was detected in 52 (33%) patients. The primary composite end‐point was more frequent in NSVT group [11.5% vs. 2.8%; p = .04]. Patients with NSVT were (i) older at the time of initial implant (age 25 vs. 18 years, p = .011) and more frequently demonstrated (ii) systemic ventricular dysfunction (44% vs. 26%; p = .015), as well as (iii) history of ventriculotomy (38% vs. 21%; p = .017).ConclusionsIn our repaired ACHD cohort, we noted a significant association between device‐detected‐NSVT and the primary composite end‐point of sustained VT/VF or SCD. Systemic ventricular dysfunction and history of ventriculotomy were more frequent in the NSVT group and likely constituted the clinical milieu.