Hemodynamical consequences and tolerance of sustained ventricular tachycardia
Factors underlying clinical tolerance and hemodynamic consequences of monomorphic sustained ventricular tachycardia (VT) need to be clarified. Intra-arterial pressures (IAP) during VT were collected in patients admitted for VT ablation and correlated to clinical, ECG and baseline echocardiographical...
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| creator | Delasnerie, Hubert Biendel, Caroline Elbaz, Meyer Mandel, Franck Beneyto, Maxime Domain, Guillaume Voglimacci-Stephanopoli, Quentin Mondoly, Pierre Delmas, Clement Bongard, Vanina Rollin, Anne Maury, Philippe |
| description | Factors underlying clinical tolerance and hemodynamic consequences of monomorphic sustained ventricular tachycardia (VT) need to be clarified.
Intra-arterial pressures (IAP) during VT were collected in patients admitted for VT ablation and correlated to clinical, ECG and baseline echocardiographical parameters.
114 VTs from 58 patients were included (median 67 years old, 81% ischemic heart disease, median left ventricular ejection fraction 30%). 61 VTs were untolerated needing immediate termination (54%). VT tolerance was tightly linked to the evolution of IAPs. Faster VT rates (p |
| doi_str_mv | 10.1371/journal.pone.0285802 |
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Intra-arterial pressures (IAP) during VT were collected in patients admitted for VT ablation and correlated to clinical, ECG and baseline echocardiographical parameters.
114 VTs from 58 patients were included (median 67 years old, 81% ischemic heart disease, median left ventricular ejection fraction 30%). 61 VTs were untolerated needing immediate termination (54%). VT tolerance was tightly linked to the evolution of IAPs. Faster VT rates (p<0.0001), presence of resynchronization therapy (p = 0.008), previous anterior myocardial infarction (p = 0.009) and more marginally larger baseline QRS duration (p = 0.1) were independently associated with VT tolerance. Only an inferior myocardial infarction was more often present in patients with only tolerated VTs vs patients with only untolerated VTs in multivariate analysis (OR 3.7, 95% CI 1.4-1000, p = 0.03). In patients with both well-tolerated and untolerated VTs, a higher VT rate was the only variable independently associated with untolerated VT (p = 0.02). Two different patterns of hemodynamic profiles during VT could be observed: a regular 1:1 relationship between electrical (QRS) and mechanical (IAP) events or some dissociation between both. VT with the second pattern were more often untolerated compared to the first pattern (78% vs 29%, p<0.0001).
This study helps to explain the large variability in clinical tolerance during VT, which is clearly related to IAP. VT tolerance may be linked to resynchronization therapy, VT rate, baseline QRS duration and location of myocardial infarction.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0285802</identifier><identifier>PMID: 37196034</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Ablation ; Aged ; Cardiac arrhythmia ; Cardiomyopathy ; Cardiovascular disease ; Cardiovascular diseases ; Care and treatment ; Catheter Ablation ; Coronary vessels ; Diabetes ; Diagnosis ; Dissociation ; Echocardiography ; EKG ; Evaluation ; Fainting ; Heart diseases ; Hemodynamic monitoring ; Hemodynamics ; Humans ; Ischemia ; Medicine and Health Sciences ; Morphology ; Multivariate analysis ; Myocardial infarction ; Myocardial Infarction - complications ; Patients ; Physical Sciences ; Regression analysis ; Research and Analysis Methods ; Stroke Volume ; Tachycardia ; Tachycardia, Ventricular ; Variables ; Vein & artery diseases ; Ventricle ; Ventricular Function, Left ; Ventricular tachycardia</subject><ispartof>PloS one, 2023-05, Vol.18 (5), p.e0285802-e0285802</ispartof><rights>Copyright: © 2023 Delasnerie et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Delasnerie et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Delasnerie et al 2023 Delasnerie et al</rights><rights>2023 Delasnerie et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c642t-4ef31853d221b42d6fcde152ab3d161a62e6342e099cbc20e2d6f4af7c7dfdc53</cites><orcidid>0000-0002-9897-6807 ; 0000-0002-1244-734X ; 0000-0002-4800-1841</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191287/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191287/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,2106,2932,23875,27933,27934,53800,53802</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37196034$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Johnson, Daniel M.</contributor><creatorcontrib>Delasnerie, Hubert</creatorcontrib><creatorcontrib>Biendel, Caroline</creatorcontrib><creatorcontrib>Elbaz, Meyer</creatorcontrib><creatorcontrib>Mandel, Franck</creatorcontrib><creatorcontrib>Beneyto, Maxime</creatorcontrib><creatorcontrib>Domain, Guillaume</creatorcontrib><creatorcontrib>Voglimacci-Stephanopoli, Quentin</creatorcontrib><creatorcontrib>Mondoly, Pierre</creatorcontrib><creatorcontrib>Delmas, Clement</creatorcontrib><creatorcontrib>Bongard, Vanina</creatorcontrib><creatorcontrib>Rollin, Anne</creatorcontrib><creatorcontrib>Maury, Philippe</creatorcontrib><title>Hemodynamical consequences and tolerance of sustained ventricular tachycardia</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Factors underlying clinical tolerance and hemodynamic consequences of monomorphic sustained ventricular tachycardia (VT) need to be clarified.
Intra-arterial pressures (IAP) during VT were collected in patients admitted for VT ablation and correlated to clinical, ECG and baseline echocardiographical parameters.
114 VTs from 58 patients were included (median 67 years old, 81% ischemic heart disease, median left ventricular ejection fraction 30%). 61 VTs were untolerated needing immediate termination (54%). VT tolerance was tightly linked to the evolution of IAPs. Faster VT rates (p<0.0001), presence of resynchronization therapy (p = 0.008), previous anterior myocardial infarction (p = 0.009) and more marginally larger baseline QRS duration (p = 0.1) were independently associated with VT tolerance. Only an inferior myocardial infarction was more often present in patients with only tolerated VTs vs patients with only untolerated VTs in multivariate analysis (OR 3.7, 95% CI 1.4-1000, p = 0.03). In patients with both well-tolerated and untolerated VTs, a higher VT rate was the only variable independently associated with untolerated VT (p = 0.02). Two different patterns of hemodynamic profiles during VT could be observed: a regular 1:1 relationship between electrical (QRS) and mechanical (IAP) events or some dissociation between both. VT with the second pattern were more often untolerated compared to the first pattern (78% vs 29%, p<0.0001).
This study helps to explain the large variability in clinical tolerance during VT, which is clearly related to IAP. VT tolerance may be linked to resynchronization therapy, VT rate, baseline QRS duration and location of myocardial infarction.</description><subject>Ablation</subject><subject>Aged</subject><subject>Cardiac arrhythmia</subject><subject>Cardiomyopathy</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Care and treatment</subject><subject>Catheter Ablation</subject><subject>Coronary vessels</subject><subject>Diabetes</subject><subject>Diagnosis</subject><subject>Dissociation</subject><subject>Echocardiography</subject><subject>EKG</subject><subject>Evaluation</subject><subject>Fainting</subject><subject>Heart diseases</subject><subject>Hemodynamic monitoring</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Medicine and Health Sciences</subject><subject>Morphology</subject><subject>Multivariate analysis</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - complications</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Regression analysis</subject><subject>Research and Analysis Methods</subject><subject>Stroke Volume</subject><subject>Tachycardia</subject><subject>Tachycardia, Ventricular</subject><subject>Variables</subject><subject>Vein & artery diseases</subject><subject>Ventricle</subject><subject>Ventricular Function, Left</subject><subject>Ventricular 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consequences and tolerance of sustained ventricular tachycardia</title><author>Delasnerie, Hubert ; Biendel, Caroline ; Elbaz, Meyer ; Mandel, Franck ; Beneyto, Maxime ; Domain, Guillaume ; Voglimacci-Stephanopoli, Quentin ; Mondoly, Pierre ; Delmas, Clement ; Bongard, Vanina ; Rollin, Anne ; Maury, Philippe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c642t-4ef31853d221b42d6fcde152ab3d161a62e6342e099cbc20e2d6f4af7c7dfdc53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Ablation</topic><topic>Aged</topic><topic>Cardiac arrhythmia</topic><topic>Cardiomyopathy</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Care and treatment</topic><topic>Catheter Ablation</topic><topic>Coronary vessels</topic><topic>Diabetes</topic><topic>Diagnosis</topic><topic>Dissociation</topic><topic>Echocardiography</topic><topic>EKG</topic><topic>Evaluation</topic><topic>Fainting</topic><topic>Heart diseases</topic><topic>Hemodynamic monitoring</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Medicine and Health Sciences</topic><topic>Morphology</topic><topic>Multivariate analysis</topic><topic>Myocardial infarction</topic><topic>Myocardial Infarction - complications</topic><topic>Patients</topic><topic>Physical Sciences</topic><topic>Regression analysis</topic><topic>Research and Analysis Methods</topic><topic>Stroke Volume</topic><topic>Tachycardia</topic><topic>Tachycardia, Ventricular</topic><topic>Variables</topic><topic>Vein & artery diseases</topic><topic>Ventricle</topic><topic>Ventricular Function, Left</topic><topic>Ventricular 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One</addtitle><date>2023-05-17</date><risdate>2023</risdate><volume>18</volume><issue>5</issue><spage>e0285802</spage><epage>e0285802</epage><pages>e0285802-e0285802</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Factors underlying clinical tolerance and hemodynamic consequences of monomorphic sustained ventricular tachycardia (VT) need to be clarified.
Intra-arterial pressures (IAP) during VT were collected in patients admitted for VT ablation and correlated to clinical, ECG and baseline echocardiographical parameters.
114 VTs from 58 patients were included (median 67 years old, 81% ischemic heart disease, median left ventricular ejection fraction 30%). 61 VTs were untolerated needing immediate termination (54%). VT tolerance was tightly linked to the evolution of IAPs. Faster VT rates (p<0.0001), presence of resynchronization therapy (p = 0.008), previous anterior myocardial infarction (p = 0.009) and more marginally larger baseline QRS duration (p = 0.1) were independently associated with VT tolerance. Only an inferior myocardial infarction was more often present in patients with only tolerated VTs vs patients with only untolerated VTs in multivariate analysis (OR 3.7, 95% CI 1.4-1000, p = 0.03). In patients with both well-tolerated and untolerated VTs, a higher VT rate was the only variable independently associated with untolerated VT (p = 0.02). Two different patterns of hemodynamic profiles during VT could be observed: a regular 1:1 relationship between electrical (QRS) and mechanical (IAP) events or some dissociation between both. VT with the second pattern were more often untolerated compared to the first pattern (78% vs 29%, p<0.0001).
This study helps to explain the large variability in clinical tolerance during VT, which is clearly related to IAP. VT tolerance may be linked to resynchronization therapy, VT rate, baseline QRS duration and location of myocardial infarction.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>37196034</pmid><doi>10.1371/journal.pone.0285802</doi><tpages>e0285802</tpages><orcidid>https://orcid.org/0000-0002-9897-6807</orcidid><orcidid>https://orcid.org/0000-0002-1244-734X</orcidid><orcidid>https://orcid.org/0000-0002-4800-1841</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2023-05, Vol.18 (5), p.e0285802-e0285802 |
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| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Ablation Aged Cardiac arrhythmia Cardiomyopathy Cardiovascular disease Cardiovascular diseases Care and treatment Catheter Ablation Coronary vessels Diabetes Diagnosis Dissociation Echocardiography EKG Evaluation Fainting Heart diseases Hemodynamic monitoring Hemodynamics Humans Ischemia Medicine and Health Sciences Morphology Multivariate analysis Myocardial infarction Myocardial Infarction - complications Patients Physical Sciences Regression analysis Research and Analysis Methods Stroke Volume Tachycardia Tachycardia, Ventricular Variables Vein & artery diseases Ventricle Ventricular Function, Left Ventricular tachycardia |
| title | Hemodynamical consequences and tolerance of sustained ventricular tachycardia |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-01T01%3A35%3A07IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Hemodynamical%20consequences%20and%20tolerance%20of%20sustained%20ventricular%20tachycardia&rft.jtitle=PloS%20one&rft.au=Delasnerie,%20Hubert&rft.date=2023-05-17&rft.volume=18&rft.issue=5&rft.spage=e0285802&rft.epage=e0285802&rft.pages=e0285802-e0285802&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0285802&rft_dat=%3Cgale_plos_%3EA749618192%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2814785719&rft_id=info:pmid/37196034&rft_galeid=A749618192&rft_doaj_id=oai_doaj_org_article_368ceac2a5b74604afa33713518ed14b&rfr_iscdi=true |