Clinical characteristics of patients with sustained ventricular arrhythmias after sacubitril/valsartan initiation


Por: Vicent, L, Mendez-Zurita, F, Vinolas, X, Alonso-Martin, C, Arbos, CM, Pamies, J, Alcalde, RO, Juarez, M, Bruna, V, Devesa, C, Sousa-Casasnovas, I, Fernandez-Aviles, F, Martinez-Selles, M

Publicada: 1 ene 2020
Resumen:
Our aim was to describe the clinical profile of patients presenting sustained ventricular arrhythmias after sacubitril/valsartan (SV) initiation. All cases of sustained ventricular arrhythmias in patients receiving SV were consecutively recorded in two centers. Nineteen patients had sustained ventricular arrhythmias after SV. All were men and were previously receiving angiotensin-converting enzyme inhibitors, or angiotensin II receptor blockers before SV initiation. Fifteen patients (78.9%) had electrical stability in the previous 6 months. Nine patients (47.4%) initiated SV at the lowest available dose (24/26 mg). Globally, in all but five patients alive at discharge, SV was discontinued after the event. Six patients presented new arrhythmic events after discontinuation of SV. Two deaths and three heart transplants occurred (one due to heart failure and the other two due to persistent ventricular arrhythmias). All patients had a high arrhythmic risk, and 17 (89.5%) had an implanted cardioverter defibrillator. No specific triggers for the arrhythmic event were found. Male sex and previous episodes of ventricular arrhythmias could be associated with an increased risk of sustained ventricular tachycardia after SV initiation. Discontinuation of the drug might be an additional approach to enable a better control of ventricular arrhythmias in some patients.

Filiaciones:
Vicent, L:
 Hosp Gen Univ Gregorio Maranon, CIBERCV, Serv Cardiol, Calle Dr Esquerdo 46, Madrid 28007, Spain

Mendez-Zurita, F:
 Hosp La Santa Creu & St, Serv Cardiol, Barcelona, Spain

Vinolas, X:
 Hosp La Santa Creu & St, Serv Cardiol, Barcelona, Spain

Alonso-Martin, C:
 Hosp La Santa Creu & St, Serv Cardiol, Barcelona, Spain

Arbos, CM:
 Hosp La Santa Creu & St, Serv Cardiol, Barcelona, Spain

Pamies, J:
 Hosp La Santa Creu & St, Serv Cardiol, Barcelona, Spain

Alcalde, RO:
 Hosp La Santa Creu & St, Serv Cardiol, Barcelona, Spain

Juarez, M:
 Hosp Gen Univ Gregorio Maranon, CIBERCV, Serv Cardiol, Calle Dr Esquerdo 46, Madrid 28007, Spain

Bruna, V:
 Hosp Gen Univ Gregorio Maranon, CIBERCV, Serv Cardiol, Calle Dr Esquerdo 46, Madrid 28007, Spain

Devesa, C:
 Hosp Gen Univ Gregorio Maranon, CIBERCV, Serv Cardiol, Calle Dr Esquerdo 46, Madrid 28007, Spain

Sousa-Casasnovas, I:
 Hosp Gen Univ Gregorio Maranon, CIBERCV, Serv Cardiol, Calle Dr Esquerdo 46, Madrid 28007, Spain

Fernandez-Aviles, F:
 Hosp Gen Univ Gregorio Maranon, CIBERCV, Serv Cardiol, Calle Dr Esquerdo 46, Madrid 28007, Spain

 Univ Complutense, Madrid, Spain

Martinez-Selles, M:
 Hosp Gen Univ Gregorio Maranon, CIBERCV, Serv Cardiol, Calle Dr Esquerdo 46, Madrid 28007, Spain

 Univ Complutense, Madrid, Spain

 Univ Europea, Madrid, Spain
ISSN: 09108327





HEART AND VESSELS
Editorial
SPRINGER, ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES, Japón
Tipo de documento: Article
Volumen: 35 Número: 1
Páginas: 136-142
WOS Id: 000511691600018
ID de PubMed: 31230095

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