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Journal Articles Heart Rhythm Year : 2022

Outcome of Patients with Early Repolarization Pattern and Syncope

1 CHU Bordeaux
2 ITX-lab - ITX-lab unité de recherche de l'institut du thorax UMR1087 UMR6291
3 CHU Nantes - Centre hospitalier universitaire de Nantes
4 CHU Trousseau [Tours]
5 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
6 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
7 ORPHY (EA 4324) - Optimisation des régulations physiologiques
8 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
9 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
10 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
11 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
12 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
13 LTSI - Laboratoire Traitement du Signal et de l'Image
14 Service de Cardiologie [CHU de Dijon]
15 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
16 Service de cardiologie [Centre Hospitalier de la Côte Basque, Bayonne]
17 CIC - CHU Bichat
18 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
19 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
20 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
21 Service de cardiologie [Strasbourg]
22 NanoRegMed - Nanomédecine Régénérative
23 Institut du Thorax [Nantes]
24 IHU-LIRYC
25 UB - Université de Bordeaux
Tsukasa Kamakura
Nicolas Clementy
Pascal Chavernac
  • Function : Author
Cédric Giraudeau
  • Function : Author
Anne Quentin
  • Function : Author
Nicolas Derval
  • Function : Author
Michel Haissaguerre
  • Function : Author
Vincent Probst
  • Function : Author
Frederic Sacher
  • Function : Author

Abstract

Background Syncope in patients with an early repolarization (ER) pattern presents a challenge for clinicians as it has been identified as an indicator of a higher risk of life-threatening ventricular arrhythmias (VAs). Objectives This study aimed to analyze the outcome of patients with an ER pattern and syncope and to evaluate the factors predictive of VAs. Methods Over a period of 5 years, we enrolled 143 patients with an ER pattern and syncope in a multicenter prospective registry. Results After the initial examinations, 97 patients (67.8%) were implanted with a device allowing electrocardiogram monitoring, including 84 (58.7%) with an implantable loop recorder. During a mean follow-up period of 68 ± 34 months, we documented 16 arrhythmias presumably responsible for syncope (5 VAs, 10 bradycardias, and 1 supraventricular tachycardia). Additionally, recurrent syncope not associated with electrocardiogram documentation occurred in 16 patients (11.2%). The cause of syncope was identified in 23 of 97 patients with a monitoring device (23.8%). The 5-year incidence of VAs and arrhythmic events presumably responsible for syncope was 4.9% and 11.0%, respectively. Patients who developed VAs showed no prodromes or specific triggers at the time of syncope. Neither the presence of a family history of sudden cardiac death nor the previously reported high-risk electrocardiographic parameters differed between patients with and without VAs. Conclusion VAs occurred in 4.9% of patients with an ER pattern and syncope. Device implantation based on detailed history taking seems to be a reasonable strategy. Previously reported high-risk electrocardiographic patterns did not identify patients with VAs.
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Dates and versions

hal-03636124 , version 1 (04-12-2023)

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Tsukasa Kamakura, Jean-Baptiste Gourraud, Nicolas Clementy, Philippe Maury, Jacques Mansourati, et al.. Outcome of Patients with Early Repolarization Pattern and Syncope. Heart Rhythm, 2022, ⟨10.1016/j.hrthm.2022.03.1233⟩. ⟨hal-03636124⟩
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