title: Risk for life-threatening arrhythmia in newly diagnosed peripartum cardiomyopathy with low ejection fraction: a German multi-centre analysis.
abstract: BACKGROUND
  Peripartum cardiomyopathy (PPCM) is a rare cardiomyopathy characterized by an acute reduction in left ventricular ejection fraction (LVEF). Sudden deaths during the course of PPCM are reported to be elevated, the underlying mechanisms remains unknown. The aim of the present multi-centre study was to evaluate the arrhythmia burden in a multi-centre approach in patients with PPCM using a wearable cardioverter/defibrillator (WCD).
  
  
  RESULTS
  Forty-nine patients from 16 German centres with newly diagnosed PPCM and LVEF ≤35% receiving a WCD were included in this retrospective analysis. Mean follow-up was 15 ± 10 months. At diagnosis, mean age was 33 ± 5 years, parity was 2.1 ± 1.6, LVEF was 21 ± 7%, NYHA functional class was 3.4 ± 0.7. Mean wear time was 120 ± 106 days, mean wear time per day was 21.4 ± 3.3 h. Six (12%) patients presented eight ventricular tachyarrhythmias during WCD period: five episodes of VF, two sustained ventricular tachycardia (VT) and one non-sustained VT occurred.
  
  
  CONCLUSIONS
  This multicentre study underpins the elevated risk for ventricular tachyarrhythmias in patients with newly diagnosed PPCM and reduced LVEF. A WCD should be considered for 3-6 months in these patients to prevent sudden cardiac death from ventricular tachyarrhythmias.
authors.affiliation: Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. duncker.david@mh-hannover.de.
authors.forename: David
authors.initials: D
authors.lastname: Duncker
authors.affiliation: Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Westenfeld
authors.affiliation: II. Medical Clinic, Department of Electrophysiology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Konrad
authors.affiliation: Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Pfeffer
authors.affiliation: Lukaskrankenhaus Neuss, Neuss, Germany.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Correia de Freitas
authors.affiliation: Department III of Internal Medicine, University of Cologne, Heart Center, Cologne, Germany.
authors.forename: Roman
authors.initials: R
authors.lastname: Pfister
authors.affiliation: Department of Cardiology, Medical University Hospital, Heidelberg, Germany.
authors.forename: Dierk
authors.initials: D
authors.lastname: Thomas
authors.affiliation: Cardioangiologisches Centrum Bethanien, Medizinische Klinik III, Markus Krankenhaus, Frankfurt am Main, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Fürnkranz
authors.affiliation: Department of Internal Medicine II, Cardiology, University Hospital Bonn, Bonn, Germany.
authors.forename: René P
authors.initials: RP
authors.lastname: Andrié
authors.affiliation: Department of Internal Medicine I (Cardiology, Angiology, Pneumology and Internal Intensive Care Medicine), University Hospital, RWTH Aachen University, Aachen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Napp
authors.affiliation: Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany.
authors.forename: Jörn
authors.initials: J
authors.lastname: Schmitt
authors.affiliation: Praxisklinik Herz und Gefäße, Kardiologie-Angiologie-Radiologie-Nuklearmedizin, Dresden, Germany.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Karolyi
authors.affiliation: Department of Medicine I, University Hospital Munich, Campus Grosshadern, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Reza
authors.initials: R
authors.lastname: Wakili
authors.affiliation: Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Denise
authors.initials: D
authors.lastname: Hilfiker-Kleiner
authors.affiliation: Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Johann
authors.initials: J
authors.lastname: Bauersachs
authors.affiliation: Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Veltmann
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D009202:Cardiomyopathies / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control; D047548:Defibrillators; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D058725:Peripartum Period; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology*; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Peripartum cardiomyopathy; Sudden cardiac death; Ventricular tachyarrhythmia; Wearable cardioverter/defibrillator