The Utility of Ventricular Premature Burden Detected by Ambulatory ECG Monitoring in Patients with Dilated Non Ischemic Cardiomyopathy for Risk Assessment of Lethal Ventricular Arrhythmias

Abstract

SUMMARY S udden cardiac death (SCD) is an important cause of mortality worldwide. Although SCD is most often associated with coronary heart disease, the risk of SCD in patients with idiopathic dilated cardiomyopathy is well-established. A variety of risk stratification tools have been investigated, although the optimal strategy remains unknown. Identification of the arrhythmogenic substrate and treatment of ventricular arrhythmias in these subgroups can be challenging. The aim of our study was to evaluate the utility of ventricular premature burden detected by ambulatory electrocardiographic monitoring (Holter ECG) in patients with dilated non ischemic cardiomyopathy for short term risk assessment of lethal ventricular arrhythmias. 60 patients with dilated cardiomyopathy were followed up for 6 months for the risk of sudden death, ventricular tachycardia, syncope, DC shock (hemodynamically unstable ventricular tachycardia) & the need for electrophysiological study and ablation. Selected patients were subjected to thorough history taking and clinical examination, ECG, Echocardiography. Thereafter 24 hours Holter was done with special emphasis on Lown's grading system.