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
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