Analysis Of Etiological Or Associated Factors In Hospitalized Cases Of Ventricular Tachycardia:7 Years Of Experiences In A Single Center

Part ?:The Clinical Characteristics and Management in Hospitalized Patients wtih Ventricular Tachycardia:Single Center Experience[Objectives]:Ventricular tachycardia(VT)is a common arrhythmia in clinic,occurring mainly in patients with structural heart disease and heart failure,but also found in patients with no significant structural heart disease.Investigation on the cause of VT abroad has long been reported,but in China,the relevant information is scace,and understanding etiology of hospitalized VT patients in clinical practice is necessary.In recent years,the diagnosis and treatment of VT has made significant progress,including drug therapy,ICD and catheter ablation,followed by relevant treatment guidelines have emerged,but the standardization of the treatment in the real world is also worth exploring.[Methods]:The clinical data in hospitalized patients with ventricular tachycardia from our center in January 2006?December 2012were analyzed retrospectively.According to the presence or absence of structural heart disease,all VT patients were divided into organic and non-organic ventricular tachycardia and their clinical characteristics,laboratory tests and imaging,treatment and outcome between the two groups were analyzed.[Results]:(1)Basic clinical characteristics:A total of 430 patients with ventricular tachycardia were enrolled,including 235 cases of ventricular tachycardia with structural heart disease and 195 cases of patients without structural heart disease.For the first group,mean 51.8 ± 17.35 years,males accounted for 71.9%,monomorphic ventricular tachycardia(86.2%),cardiac function 2.2 ± 1.0 grade,clinical symptoms are palpitations(82.6%),shortness of breath 54.9%,syncope 28.5%,fatigue 27.7%,angina 13.2%;For the second group,an average age of 39.0 ±17.2 years,males accounted for 61.8%,clinical symptoms,palpitations 87.7%,shortness of breath 31.8%,syncope 28.2%,fatigue 17.9%,angina 13.2%.(2)Etiology:For VT patients with structural heart disease,the most common cause is ARVC,which is accounted for 23.8%,followed by coronary disease which is 23%,and DCM 20.9%,hypertensive heart disease 7.7%,HCM 4..3%,valve heart disease 4.3%.For VT patients without structural heart disease,idiopathic VT is the most common.(3)Treatment:Treatment for VT patients with structural heart disease includes:?-blockers 72.8%,Cordarone 49.4%,CCB 11.5%;Propafenone 20.4%;radiofrequency ablation 28.5%,ICD 26.8%,CRT 10.2%.And Treatment for VT patients without structural heart disease includes:?-blockers 43.1%,propafenone 22.6%,CCB 15.4%,;radiofrequency ablation63.1%;ICD8.2%.[Conclusions]:(1)Etiologies of the clinical VTs were idiopathic ventricular tachycardia,ARVC,coronary heart disease,DCM.(2)In clinical practice,the treatment of ventricular tachycardia is to be standardized.Part ?:The risk factor analysis on the ventricular tachycardia patients with structual heart disease.[Objectives]:The purpose of this research is to analysis the risk factors on the ventricular tachycardia patients with structual heart disease,to facilitate identification of high-risk patients for clinicians,therefor reducing the incidence of SCD.[Methods]:A total of 430 cases of hositalized ventricular tachycardia patients entrolled in our hospitalduring January 2006?December 2012 were retrospectively analyzed.the patients were devided into patents with strucural heart disease and patients without heart disaese according to the presence or absence of structural heart disease.The basic clinical data,laboratory tests and other clinical indicators were analyzed between two groups.[Results]:There are significant differences in age,gender,smoking history,drinking history,blood routine and biochemistry between two groups.This study shows that patients with structural heart disease are prone to be elderly,male,with more smoking and drinking history.Further study found that age(OR = 1.892,95%CI =1.569-2.280,p = 2.280),gender(OR = 1.714,95%CI = 1.165-2.610,p =0.007),smoking history(OR=2.129,95%CI=1.278-3.546,p = 0.004),history of alcohol consumption(OR = 1.983,95%CI= 1.156-3.313,p =0.009),white blood cell count(OR=1.355,95%CI = 1.133,p = 1.620),ALT(OR = 1.404,95%CI =1.171-1.682,p = 0.000),AST(OR=1.507,95%CI=1.254-1.811,p = 0.000),ALP(OR = 1.217,95%CI = 1.0181.455,p = 0.031),Glu(OR = 1.365,95%CI =1.138-1.6365,p = 0.001),Cr(OR= 1.767,95%CI=1.457-2.141,p = 0.000),UA(OR=1.293,95%CI= 1.080-1.549,p = 0.005)index is dependent risk factor associated with ventricular tachycardia in patients with structural heart disease.[Conclusions]:The results of this study showed that age,male gender,smoking history,alcohol consumption,blood glucose levels,elevated white blood cellcount,and liver and kidney dysfunction is an independent risk factor for ventricular tachycardia in patients with structural heart disease.Part ?:Analysis of heart rate variability in patients with ventricular tachycardia[Objectives]:Analysis of heart rate variability in patients with ventricular tachycardia,and explore the relevance of their occurrence and ventricular arrhythmias[Methods]:Retrospective analysis clinical data of VT patients enrolled during January 1,2006-December 31,2012 in our hospital.All patients with complete Holter data were analyzed.The selected patients were devided two groups according to median113ms of SDNN:group with SDNN>113msand group with SDNN =113msgroup.then basicclinical dataof two groupsof patients will be compared,as well as Echocardiography,Holter monitoring,the occurrence of ventricular arrhythmias.[Results]:A total of 504 cases of VT patients were entrolled from January 1,2006 to December 31,2012.Repeated hospitalization were excluded.At last,a total of 263 patients with complete 24-hour Holter ECG data were analyzed,with a mean age of 46.6 ± 17.6(years),Men 178 cases(67.7%).SDNN>113ms group:average age was40.9 ±16.9 years,males accounted for66.4%,AF history of 4.4%,DM history of0.7%,COPD history of 0.0%,the rate of occurrence of organicVTis 46%,NYHA ?-? accounted for28.5%,while SDNN ? 113ms group mean49.7 ±16.3,males accounted for 56.3%.AF history of 3.2%,DM history of 7.9%,COPD history of4.8%,the incidence of organic VT is 61.9%,NYHII-IV49.2%.[Conclusions]:(1)There is a significant difference between the two groups in age,HR,ECG index,NYHA classification,the occurrence of ventricular arrhythmias.(2)Patients of SDNN ? 113msg roup are older,and showed higher NYHA functional class,LVEF significantly reduced,higher rate of the occurrence of organicVT,and history of diabetes and a history of COPD was also significantly higher than SDNN>113ms groups.(3)The disbalance of autonomic nerve damage may play a important role in occurence and development of ventricular arrhythmias,and may be related to the severity of the patient's clinical symptoms.