title: Non-sustained ventricular tachycardia in patients with congenital heart disease: An important sign?
abstract: BACKGROUND
  Sustained ventricular tachycardia (susVT) and ventricular fibrillation (VF) are observed in adult patients with congenital heart disease (CHD). These dysrhythmias may be preceded by non-sustained ventricular tachycardia (NSVT). The aims of this study are to examine the 1] time course of ventricular tachyarrhythmia (VTA) in a large cohort of patients with various CHDs and 2] the development of susVT/VF after NSVT.
  
  
  METHODS
  In this retrospective study, patients with VTA on ECG, 24-hour Holter or ICD-printout or an out-of-hospital-cardiac arrest due to VF were included. In patients with an ICD, the number of shocks was studied.
  
  
  RESULTS
  Patients (N=145 patients, 59% male) initially presented with NSVT (N=103), susVT (N=25) or VF (N=17) at a mean age of 40 ± 14 years. Prior to VTA, 58 patients had intraventricular conduction delay, 14 an impaired ventricular dysfunction and 3 had coronary artery disease. susVT/VF rarely occurred in patients with NSVT (N=5). Fifty-two (36%) patients received an ICD; appropriate and inappropriate shocks, mainly due to supraventricular tachycardia (SVT), occurred in respectively 15 (29%) (NSVT: N=1, susVT: N=9, VF: N=5) and 12 (23%) (NSVT: N=4, susVT: N=5, VF: N=3) patients.
  
  
  CONCLUSIONS
  VTA in patients with CHD appear on average at the age of 40 years. susVT/VF rarely developed in patients with only NSVT, whereas recurrent episodes of susVT/VF frequently developed in patients initially presenting with susVT/VF. Hence, a wait-and-see treatment strategy in patients with NSVT and aggressive therapy of both episodes of VTA and SVT in patients with susVT/VF seems justified.
authors.affiliation: Dept of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Christophe P
authors.initials: CP
authors.lastname: Teuwen
authors.affiliation: Dept of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Tanwier T T K
authors.initials: TT
authors.lastname: Ramdjan
authors.affiliation: Dept of Cardiology, Haga Hospital, The Hague, The Netherlands.
authors.forename: Marco
authors.initials: M
authors.lastname: Götte
authors.affiliation: Dept of Clinical Pharmacy and Pharmacology, University Medical Center, University of Groningen, The Netherlands.
authors.forename: Bianca J J M
authors.initials: BJ
authors.lastname: Brundel
authors.affiliation: Dept of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Reinder
authors.initials: R
authors.lastname: Evertz
authors.affiliation: Dept of Cardiology, Haga Hospital, The Hague, The Netherlands.
authors.forename: Joris W J
authors.initials: JW
authors.lastname: Vriend
authors.affiliation: Dept of Cardiology, Amphia Hospital, Breda, The Netherlands.
authors.forename: Sander G
authors.initials: SG
authors.lastname: Molhoek
authors.affiliation: Dept of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: H G
authors.initials: HG
authors.lastname: Reinhart Dorman
authors.affiliation: Dept of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: Jurren M
authors.initials: JM
authors.lastname: van Opstal
authors.affiliation: Dept of Cardiology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Thelma C
authors.initials: TC
authors.lastname: Konings
authors.affiliation: Dept of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Pepijn
authors.initials: P
authors.lastname: van der Voort
authors.affiliation: Dept of Cardiology, Inselspital, University of Bern, Switzerland.
authors.forename: Etienne
authors.initials: E
authors.lastname: Delacretaz
authors.affiliation: Dept of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Nienke J
authors.initials: NJ
authors.lastname: Wolfhagen
authors.affiliation: Dept of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Virgilla
authors.initials: V
authors.lastname: van Gastel
authors.affiliation: Dept of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: de Klerk
authors.affiliation: Dept of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Dominic A
authors.initials: DA
authors.lastname: Theuns
authors.affiliation: Dept of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: Witsenburg
authors.affiliation: Dept of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Jolien W
authors.initials: JW
authors.lastname: Roos-Hesselink
authors.affiliation: Dept of Cardiology, Boston Children's Hospital, Boston, USA.
authors.forename: John K
authors.initials: JK
authors.lastname: Triedman
authors.affiliation: Dept of Cardio-Thoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Ad J J C
authors.initials: AJ
authors.lastname: Bogers
authors.affiliation: Dept of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands. Electronic address: n.m.s.degroot@erasmusmc.nl.
authors.forename: Natasja M S
authors.initials: NM
authors.lastname: de Groot
mesh_terms: D000328:Adult; D017668:Age of Onset; D017147:Defibrillators, Implantable; D005260:Female; D006330:Heart Defects, Congenital / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Congenital heart defects; Implantable cardioverter defibrillator; Ventricular tachyarrhythmia