Dear editor,
Verheul et al. present their important data from a Dutch registry of patients with idiopathic ventricular fibrillation (iVF) [1]. They underline the importance of comprehensive diagnostic testing to find a specific diagnosis. An underappreciated topic is prediction of future arrhythmic events as 74% of their patients do not experience appropriate ICD therapy. These young patients are prone to complications due to risk of electrode failure and need for multiple future interventions.
Anzeige
We previously demonstrated that secondary prevention patients with an unclear cause of ventricular arrhythmia received significantly less appropriate ICD therapy compared to those with a clear cause (14% vs. 41%). Considering that the rate of first appropriate therapy was highest in the first two years, [2] patients who do not receive appropriate therapy within the lifetime of their first ICD may not derive sufficient benefit to warrant ICD replacement.
We hope that the Dutch iVF registry can provide predictors for future arrhythmic events to optimally advise patients in the difficult decision-making process surrounding ICD replacement [3]. If we can identify patients with low risk of recurrence, ICD implantation may even be omitted altogether.
Funding
There was no funding obtained for this manuscript.
Conflict of interest
A.B.P. Noordman and A.H. Maass declare that they have no competing interests.
Anzeige
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the articleʼs Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the articleʼs Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
