Abstract
PO-06-129 CLINICAL, ELECTROCARDIOGRAPHIC, AND CARDIAC MAGNETIC RESONANCE IMAGING RISK FACTORS ASSOCIATED WITH VENTRICULAR TACHYARRHYTHMIAS IN NONISCHEMIC CARDIOMYOPATHY (MARVEN STUDY)
Heart rhythm, Vol.22(4), pp.S688-S688
04/2025
DOI: 10.1016/j.hrthm.2025.03.1670
Abstract
Background
Risk stratification in nonischemic cardiomyopathy (NICM) remains a challenge. Current guidelines for device implantation are based on left ventricular ejection fraction and QRS duration.
Objective
The aim of the MARVEN study was to evaluate clinical and imaging models for predicting ventricular arrhythmias in patients undergoing cardiac resynchronization therapy defibrillator (CRT-D) or implantable cardioverter defibrillator (ICD) implantation.
Methods
NICM patients scheduled for CRT-D or ICD implantation were recruited across 27 participating US sites and underwent evaluation of NSVT in Holter monitoring or prior ECG recordings and cardiac MRI (CMR) exams with cine and late gadolinium enhancement (LGE) imaging prior to device implant. LGE presence, location, and extent by AHA segments were evaluated. The primary endpoint consisted of ventricular tachycardia/fibrillation (VT/VF) >188 bpm; secondary endpoint included VT/VF>188 bpm or death.
Results
The study enrolled 303 patients (60±13 years old, 52% women). There were 42% of patients with NYHA class III, 215 (71%) had LBBB, mean EF was 24±6% (62% having EF≤25%), 57 (19%) had NSVT. Pharmacological treatment was consistent with current guidlines with 94% of patients on ARNI/ACE/ARB, 91% on BB, 57% on MRA and 27% in SGLT2i, CRT-D were implanted in 225 patients (74%). The 2-year risk of VT/VF>188 bpm was 6% and VT/VF/death 8% with 2% death at 2 years. LGE was found in 78% of studied patients. The number and location of LGE segments by CMR did not predict cardiac events in this patient population. NSVT (HR=3.3.; p=0.010) and non-LBBB QRS morphology (HR=2.8; p=0.025) were identified as significant predictors of VT/VF events.
Conclusion
In a contemporary cohort of NICM patients treated with contemporary pharmacological therapy and CRT-D or ICD cardiac event rates consisting of VT/VF>188 bpm were low. Presence of NSVT and non-LBBB QRS morphology were identified as significant predictors of tachyarrhythmias, whereas LGE did not further risk startify this population.
Details
- Title: Subtitle
- PO-06-129 CLINICAL, ELECTROCARDIOGRAPHIC, AND CARDIAC MAGNETIC RESONANCE IMAGING RISK FACTORS ASSOCIATED WITH VENTRICULAR TACHYARRHYTHMIAS IN NONISCHEMIC CARDIOMYOPATHY (MARVEN STUDY)
- Creators
- Wojciech ZarebaMatthew A. BernabeiChetan ShenoyMadhu ReddySamuel L. JohnstonSrinivas RajshekerM. Rizwan AfzalMayer RashtianPeter A. SantucciDavid T. HuangStephen L. WintersKristina CutterScott McNittBronislava PolonskySuzanne SmartKarolina M. Zareba
- Resource Type
- Abstract
- Publication Details
- Heart rhythm, Vol.22(4), pp.S688-S688
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.hrthm.2025.03.1670
- ISSN
- 1547-5271
- Language
- English
- Date published
- 04/2025
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984815911802771
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