In:
Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 8 ( 2021-7-15)
Abstract:
Background: The clinical significance and outcomes of ventricular tachyarrhythmias (VTa) in patients undergoing valve replacement have rarely been reported. Objective: This study aimed to investigate the incidence and outcome of VTa after surgical valve replacement. Methods: We conducted a population-based retrospective cohort study using data obtained from the Taiwan National Health Insurance Research Database. In total, 10,212 patients were selected after 1:1 propensity-score matching based on the type of prosthetic valve used (mechanical vs. bioprosthetic). Various outcomes during long-term follow-up were analyzed. Results: After a median follow-up period of 59.6 months, the crude incidence rate of VTa after surgical valve replacement was 4.8/1,000 person-years, and the cumulative incidence of VTa persistently increased after surgery. Furthermore, the occurrences of VTa after valve replacement significantly increased the risk of cardiovascular (CV) death ( P & lt; 0.001, HR 1.67, 95% CI 1.41–1.96), stroke- ( P & lt; 0.001, HR 1.66, 95% CI 1.37–2.01), atrial fibrillation- ( P & lt; 0.001, HR 2.80, 95% CI 2.42–3.24), and congestive heart failure-related hospitalization ( P & lt; 0.001, HR 2.61, 95% CI 2.30–2.95). Among patients with VTa, all-cause mortality ( P = 0.001, HR 0.49, 95% CI 0.32–0.75) and CV death ( P = 0.047, HR 0.58, 95% CI 0.34–0.99) in those with implantable cardioverter-defibrillator (ICD) implantation were lower than those without. Conclusion: The crude incidence rate of VTa after surgical valve replacement was 4.8/1,000 person-years, and the cumulative incidence of VTa persistently increased during follow-up. The presence of VTa after surgical valve replacement increases hospitalization and CV death, while ICD implantation reduced the mortality rate in these patients.
Type of Medium:
Online Resource
ISSN:
2297-055X
DOI:
10.3389/fcvm.2021.676897
DOI:
10.3389/fcvm.2021.676897.s001
Language:
Unknown
Publisher:
Frontiers Media SA
Publication Date:
2021
detail.hit.zdb_id:
2781496-8
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