Rosier L. Elsevier Archives of Cardiovascular Diseases Supplements. 2020 Jan;12(1):105.
Acute myocarditis is correlated with cardiac arrhythmia in 25% of cases; ventricular tachycardia (VT) or ventricular fibrillation (VF) constitute a third of these arrhythmias. In these patients, the implantation of a cardiac defibrillator (ICD) after sustained ventricular arrhythmia remains controversial. Thus, Rosier L et al., conducted a study to evaluate the risk of major arrhythmic ventricular events (MAE) above time in patients implanted with an ICD after sustained VT/VF in the acute phase of myocarditis than those implanted for VT/VF appeared on myocarditis sequelae
The retrospective observational study incorporated patients from 2007 to 2017, implanted with an ICD after VT/VF in acute myocarditis or VT/VF on myocarditis sequelae in 15 French university hospitals. MAE was described as any appropriate interference of the defibrillator (anti-tachycardia pacing or shock) on VT/VF. 11(39%) patients of the acute myocarditis group and 24(60%) patients of the myocarditis sequelae group exhibited one or more MAE on a median follow-up period of 3 years. Kaplan-Meier MAE rate were 19% and 45% in the acute group, and 43% and 64% in the sequelae group, respectively at one and three years’ follow-up. In the two groups, there was no substantial difference in the number or type of MAEs.
Thus, it was concluded that patients who had sustained ventricular arrhythmias in acute myocarditis showed a very high risk of VT/VF recurrence during follow-up. These consequences questioned the current guidelines for ICD implantation in acute myocarditis correlated with VT/VF by exhibiting that the risk of MAE recurrence remains elevated following the resolution of the acute episode.
