AUTHOR=Li Guan-Yi , Chen Yun-Yu , Chien Kuo-Liong , Lin Yenn-Jiang , Kuo Tzu-Ting , Chung Fa-Po 

TITLE=Clinical Significance of Ventricular Tachyarrhythmias in Patients Undergoing Valve Replacement: A Nationwide Population-Based Study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.676897

DOI=10.3389/fcvm.2021.676897

ISSN=2297-055X

ABSTRACT=<p><bold>Background:</bold> The clinical significance and outcomes of ventricular tachyarrhythmias (VTa) in patients undergoing valve replacement have rarely been reported.</p><p><bold>Objective:</bold> This study aimed to investigate the incidence and outcome of VTa after surgical valve replacement.</p><p><bold>Methods:</bold> 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.</p><p><bold>Results:</bold> 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 (<italic>P</italic> &lt; 0.001, HR 1.67, 95% CI 1.41–1.96), stroke- (<italic>P</italic> &lt; 0.001, HR 1.66, 95% CI 1.37–2.01), atrial fibrillation- (<italic>P</italic> &lt; 0.001, HR 2.80, 95% CI 2.42–3.24), and congestive heart failure-related hospitalization (<italic>P</italic> &lt; 0.001, HR 2.61, 95% CI 2.30–2.95). Among patients with VTa, all-cause mortality (<italic>P</italic> = 0.001, HR 0.49, 95% CI 0.32–0.75) and CV death (<italic>P</italic> = 0.047, HR 0.58, 95% CI 0.34–0.99) in those with implantable cardioverter-defibrillator (ICD) implantation were lower than those without.</p><p><bold>Conclusion:</bold> 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.</p>