AUTHOR=Li Guan-Yi , Chen Yun-Yu , Chien Kuo-Liong , Lin Yenn-Jiang , Kuo Tzu-Ting , Chung Fa-Po 

TITLE=Clinical Significance of Ventricular Tachyarrhythmias in Patients Undergoing Valve Replacement: A Nationwide Population-Based Study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.676897

DOI=10.3389/fcvm.2021.676897

ISSN=2297-055X

ABSTRACT=Background: The clinical significance and outcomes of ventricular tachyarrhythmias (VTa) in patients undergoing valve replacement have rarely been reported.
Objective: This study aimed to investigate the incidence and outcome of VTa after surgical valve replacement. 
Methods: We conducted a population-based retrospective cohort study using data obtained from the Taiwan National Health Insurance Research Database. In total, 10,212 patients were selected after 1:1 propensity-score matching based on the type of prosthetic valve used (mechanical versus bioprosthetic). Various outcomes during long-term follow-up were analyzed.
Results: After a median follow-up period of 59.6 months, the crude incidence rate of VTa after surgical valve replacement was 4.8/1,000 person-years, and the cumulative incidence of VTa persistently increased after surgery. Furthermore, the occurrences of VTa after valve replacement significantly increased the risk of cardiovascular (CV) death (P<0.001, HR 1.67, 95% CI 1.41-1.96), stroke- (P<0.001, HR 1.66, 95% CI 1.37-2.01), atrial fibrillation- (P<0.001, HR 2.80, 95% CI 2.42-3.24), and congestive heart failure-related hospitalization (P<0.001, HR 2.61, 95% CI 2.30-2.95). Among patients with VTa, all-cause mortality (P=0.001, HR 0.49, 95% CI 0.32-0.75) and CV death (P=0.047, HR 0.58, 95% CI 0.34-0.99) in those with implantable cardioverter-defibrillator (ICD) implantation were lower than those without.
Conclusion: The crude incidence rate of VTa after surgical valve replacement was 4.8/1,000 person-years, and the cumulative incidence of VTa persistently increased during follow-up. The presence of VTa after surgical valve replacement increases hospitalization and CV death, while ICD implantation reduced the mortality rate in these patients.