Ventricular tachycardia epidemiology and demographics: Difference between revisions

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[[Ischemic heart disease]] is the most common cause of ventricular tacchycardia in the US, followed by [[cardiomyopathy]]. VT causes approximately of half of the 300,000 [[sudden deaths]] which occur out of hospital annually in the US. [[Brugada syndrome]] is thought to be the cause of half of the sudden cardiac deaths which occurs in young individuals without structural heart disease.
[[Ischemic heart disease]] is the most common cause of ventricular tacchycardia in the US, followed by [[cardiomyopathy]]. VT causes approximately of half of the 300,000 [[sudden deaths]] which occur out of hospital annually in the US. [[Brugada syndrome]] is thought to be the cause of half of the sudden cardiac deaths which occurs in young individuals without structural heart disease.


==Epidemiology and Demographics==
==Epidemiology ==
* Sustained [[ventricular tachycardia]] (VT) is an important cause of 150,000 to 300,000 out of hospital [[sudden death]]s that occur annually in the US.<ref name="pmid19768192">{{cite journal| author=Stevenson WG| title=Ventricular scars and ventricular tachycardia. | journal=Trans Am Clin Climatol Assoc | year= 2009 | volume= 120 | issue=  | pages= 403-12 | pmid=19768192 | doi= | pmc=PMC2744510 | url= }} </ref>
* Sustained [[ventricular tachycardia]] (VT) is an important cause of 150,000 to 300,000 out of hospital [[sudden death]]s that occur annually in the US.<ref name="pmid19768192">{{cite journal| author=Stevenson WG| title=Ventricular scars and ventricular tachycardia. | journal=Trans Am Clin Climatol Assoc | year= 2009 | volume= 120 | issue=  | pages= 403-12 | pmid=19768192 | doi= | pmc=PMC2744510 | url= }} </ref>


* The most common cause of [[wide complex tachycardia]] ([[WCT]]) is [[ventricular tachycardia]] ([[VT]]), which accounts for 80% of all cases of [[WCT]].<ref name="pmid11233948">{{cite journal| author=Gupta AK, Thakur RK| title=Wide QRS complex tachycardias. | journal=Med Clin North Am | year= 2001 | volume= 85 | issue= 2 | pages= 245-66, ix-x | pmid=11233948 | doi= | pmc= | url= }} </ref>  [[Supraventricular tachycardia]] (SVT) with aberrancy accounts for 15% to 20% of WCTs.  SVTs with bystander preexcitation and antidromic atrioventricular reentrant tachycardia ([[AVRT]]) account for 1% to 6% of WCTs.<ref name='book1'>Issa Z, Miller JM, Zipes DP(2009). Approach to Wide QRS Complex Tachycardias. '' Arrhythmology and Electrophysiology:
* The most common cause of [[wide complex tachycardia]] ([[WCT]]) is [[ventricular tachycardia]] ([[VT]]), which accounts for 80% of all cases of [[WCT]].<ref name="pmid11233948">{{cite journal| author=Gupta AK, Thakur RK| title=Wide QRS complex tachycardias. | journal=Med Clin North Am | year= 2001 | volume= 85 | issue= 2 | pages= 245-66, ix-x | pmid=11233948 | doi= | pmc= | url= }} </ref>   
A Companion to Braunwald's heart disease'' (1st ed., pp. 393). Philadelphia, Pa: Saunders Elsevier.</ref>
*[[Supraventricular tachycardia]] (SVT) with aberrancy accounts for 15% to 20% of WCTs.   
*SVTs with bystander preexcitation and antidromic atrioventricular reentrant tachycardia ([[AVRT]]) account for 1% to 6% of WCTs.<ref name="book1">Issa Z, Miller JM, Zipes DP(2009). Approach to Wide QRS Complex Tachycardias. '' Arrhythmology and Electrophysiology:''
A Companion to Braunwald's heart disease'' (1st ed., pp. 393). Philadelphia, Pa: Saunders Elsevier.''</ref>


* However, the underlying substrate varies: [[ischemic heart disease]] in 75–80% cases; idiopathic [[cardiomyopathy]] in 10–15%; and 1–2% due to rare monogenic [[mutation]]s in [[cardiac]] [[ion channels]] or associated proteins.<ref name='book2'> Zipes DP, Jalife J(2009). '' Cardiac electrophysiology: from cell to bedside '' (5th ed.). Philadelphia, Pa: Saunders Elsevier.</ref>  
* However, the underlying substrate varies: [[ischemic heart disease]] in 75–80% cases; idiopathic [[cardiomyopathy]] in 10–15%; and 1–2% due to rare monogenic [[mutation]]s in [[cardiac]] [[ion channels]] or associated proteins.<ref name="book2"> Zipes DP, Jalife J(2009). '' Cardiac electrophysiology: from cell to bedside '' (5th ed.). Philadelphia, Pa: Saunders Elsevier.</ref>


* [[Brugada Syndrome]] may account for up to 50% of all [[Sudden_Cardiac_Death|SCD]]s in young individuals without structural [[heart disease]]. <ref name='book2'> Zipes DP, Jalife J(2009). '' Cardiac electrophysiology: from cell to bedside '' (5th ed.). Philadelphia, Pa: Saunders Elsevier.</ref>
* [[Brugada Syndrome]] may account for up to 50% of all [[Sudden_Cardiac_Death|SCD]]s in young individuals without structural [[heart disease]]. <ref name="book2"> Zipes DP, Jalife J(2009). '' Cardiac electrophysiology: from cell to bedside '' (5th ed.). Philadelphia, Pa: Saunders Elsevier.</ref>


* The prevalence of nonsustained [[VT]] detected by 24-hour ambulatory ECGs was 4% in 98 elderly, disease-free individuals in the Baltimore Longitudinal Study of Aging,<ref name="pmid7056104">{{cite journal| author=Fleg JL, Kennedy HL| title=Cardiac arrhythmias in a healthy elderly population: detection by 24-hour ambulatory electrocardiography. | journal=Chest | year= 1982 | volume= 81 | issue= 3 | pages= 302-7 | pmid=7056104 | doi= | pmc= | url= }} </ref> 4% in 106 active elderly people,<ref name="pmid7369099">{{cite journal| author=Camm AJ, Evans KE, Ward DE, Martin A| title=The rhythm of the heart in active elderly subjects. | journal=Am Heart J | year= 1980 | volume= 99 | issue= 5 | pages= 598-603 | pmid=7369099 | doi= | pmc= | url= }} </ref> 2% in 50 elderly people without [[cardiovascular disease]],<ref name="pmid3946253">{{cite journal| author=Kantelip JP, Sage E, Duchene-Marullaz P| title=Findings on ambulatory electrocardiographic monitoring in subjects older than 80 years. | journal=Am J Cardiol | year= 1986 | volume= 57 | issue= 6 | pages= 398-401 | pmid=3946253 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3946253  }} </ref> 4% in 729 elderly women and 13% in 643 elderly men in the Cardiovascular Health Study,<ref name="pmid8106697">{{cite journal| author=Manolio TA, Furberg CD, Rautaharju PM, Siscovick D, Newman AB, Borhani NO et al.| title=Cardiac arrhythmias on 24-h ambulatory electrocardiography in older women and men: the Cardiovascular Health Study. | journal=J Am Coll Cardiol | year= 1994 | volume= 23 | issue= 4 | pages= 916-25 | pmid=8106697 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8106697  }} </ref> 3% in 135 elderly men and 2% in 297 elderly women without cardiovascular disease,<ref name="pmid11867655">{{cite journal| author=Aronow WS, Ahn C, Mercando AD, Epstein S, Kronzon I| title=Prevalence and association of ventricular tachycardia and complex ventricular arrhythmias with new coronary events in older men and women with and without cardiovascular disease. | journal=J Gerontol A Biol Sci Med Sci | year= 2002 | volume= 57 | issue= 3 | pages= M178-80 | pmid=11867655 | doi= | pmc= | url= }} </ref> 9% in 385 elderly men and 8% in 806 elderly women with [[hypertension]], [[valvular disease]], or [[cardiomyopathy]],<ref name="pmid11867655">{{cite journal| author=Aronow WS, Ahn C, Mercando AD, Epstein S, Kronzon I| title=Prevalence and association of ventricular tachycardia and complex ventricular arrhythmias with new coronary events in older men and women with and without cardiovascular disease. | journal=J Gerontol A Biol Sci Med Sci | year= 2002 | volume= 57 | issue= 3 | pages= M178-80 | pmid=11867655 | doi= | pmc= | url= }} </ref> 6% in 395 elderly men and 15% in 771 elderly women with [[coronary artery disease]] (CAD),<ref name="pmid11867655">{{cite journal| author=Aronow WS, Ahn C, Mercando AD, Epstein S, Kronzon I| title=Prevalence and association of ventricular tachycardia and complex ventricular arrhythmias with new coronary events in older men and women with and without cardiovascular disease. | journal=J Gerontol A Biol Sci Med Sci | year= 2002 | volume= 57 | issue= 3 | pages= M178-80 | pmid=11867655 | doi= | pmc= | url= }} </ref> and 5% in a well population of 80 year olds in the Bronx Longitudinal Aging Study.<ref name="pmid9494777">{{cite journal| author=Frishman WH, Sokol S, Aronson MK, Wassertheil-Smoller S, Katzman R| title=Risk factors for cardiovascular and cerebrovascular diseases and dementia in the elderly. | journal=Curr Probl Cardiol | year= 1998 | volume= 23 | issue= 1 | pages= 1-62 | pmid=9494777 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9494777  }} </ref>
== Demographics ==


* The prevalence of complex [[ventricular]] [[arrhythmia]] in elderly people in these studies was 50%,<ref name="pmid7056104">{{cite journal| author=Fleg JL, Kennedy HL| title=Cardiac arrhythmias in a healthy elderly population: detection by 24-hour ambulatory electrocardiography. | journal=Chest | year= 1982 | volume= 81 | issue= 3 | pages= 302-7 | pmid=7056104 | doi= | pmc= | url= }} </ref> 31%,<ref name="pmid7369099">{{cite journal| author=Camm AJ, Evans KE, Ward DE, Martin A| title=The rhythm of the heart in active elderly subjects. | journal=Am Heart J | year= 1980 | volume= 99 | issue= 5 | pages= 598-603 | pmid=7369099 | doi= | pmc= | url= }} </ref> 20%,<ref name="pmid3946253">{{cite journal| author=Kantelip JP, Sage E, Duchene-Marullaz P| title=Findings on ambulatory electrocardiographic monitoring in subjects older than 80 years. | journal=Am J Cardiol | year= 1986 | volume= 57 | issue= 6 | pages= 398-401 | pmid=3946253 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3946253  }} </ref> 16% in women and 28% in men,<ref name="pmid8106697">{{cite journal| author=Manolio TA, Furberg CD, Rautaharju PM, Siscovick D, Newman AB, Borhani NO et al.| title=Cardiac arrhythmias on 24-h ambulatory electrocardiography in older women and men: the Cardiovascular Health Study. | journal=J Am Coll Cardiol | year= 1994 | volume= 23 | issue= 4 | pages= 916-25 | pmid=8106697 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8106697  }} </ref> 31% in men and 30% in women without [[cardiovascular disease]],<ref name="pmid11867655">{{cite journal| author=Aronow WS, Ahn C, Mercando AD, Epstein S, Kronzon I| title=Prevalence and association of ventricular tachycardia and complex ventricular arrhythmias with new coronary events in older men and women with and without cardiovascular disease. | journal=J Gerontol A Biol Sci Med Sci | year= 2002 | volume= 57 | issue= 3 | pages= M178-80 | pmid=11867655 | doi= | pmc= | url= }} </ref> 54% in men and 55% in women with [[hypertension]], [[valvular disease]], or [[cardiomyopathy]],<ref name="pmid11867655">{{cite journal| author=Aronow WS, Ahn C, Mercando AD, Epstein S, Kronzon I| title=Prevalence and association of ventricular tachycardia and complex ventricular arrhythmias with new coronary events in older men and women with and without cardiovascular disease. | journal=J Gerontol A Biol Sci Med Sci | year= 2002 | volume= 57 | issue= 3 | pages= M178-80 | pmid=11867655 | doi= | pmc= | url= }} </ref> and 69% in men and 68% in women with [[CAD]].<ref name="pmid11867655">{{cite journal| author=Aronow WS, Ahn C, Mercando AD, Epstein S, Kronzon I| title=Prevalence and association of ventricular tachycardia and complex ventricular arrhythmias with new coronary events in older men and women with and without cardiovascular disease. | journal=J Gerontol A Biol Sci Med Sci | year= 2002 | volume= 57 | issue= 3 | pages= M178-80 | pmid=11867655 | doi= | pmc= | url= }} </ref>
=== Age ===
 
* VT is unusual in children but may occur in the postoperative cardiac setting or in patients with associated congenital heart disease.<ref name="pmid7229788">{{cite journal |vauthors=Garson A, Gillette PC, McNamara DG |title=Supraventricular tachycardia in children: clinical features, response to treatment, and long-term follow-up in 217 patients |journal=J. Pediatr. |volume=98 |issue=6 |pages=875–82 |date=June 1981 |pmid=7229788 |doi=10.1016/s0022-3476(81)80578-1 |url=}}</ref>
* Tachydysrhythmias in children are more commonly due to paroxysmal supraventricular tachycardias (PSVTs). 
* The incidence of ischemic VT increases with age.  
* VT rates peak in the middle decades of life.  
* Idiopathic VT can be observed at any age.


==References==
==References==

Revision as of 15:18, 5 December 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in Chief: Avirup Guha, M.B.B.S.[2]

Overview

Ischemic heart disease is the most common cause of ventricular tacchycardia in the US, followed by cardiomyopathy. VT causes approximately of half of the 300,000 sudden deaths which occur out of hospital annually in the US. Brugada syndrome is thought to be the cause of half of the sudden cardiac deaths which occurs in young individuals without structural heart disease.

Epidemiology

Demographics

Age

  • VT is unusual in children but may occur in the postoperative cardiac setting or in patients with associated congenital heart disease.[5]
  • Tachydysrhythmias in children are more commonly due to paroxysmal supraventricular tachycardias (PSVTs).
  • The incidence of ischemic VT increases with age.
  • VT rates peak in the middle decades of life.
  • Idiopathic VT can be observed at any age.

References

  1. ↑ Stevenson WG (2009). "Ventricular scars and ventricular tachycardia". Trans Am Clin Climatol Assoc. 120: 403–12. PMC 2744510. PMID 19768192.
  2. ↑ Gupta AK, Thakur RK (2001). "Wide QRS complex tachycardias". Med Clin North Am. 85 (2): 245–66, ix–x. PMID 11233948.
  3. ↑ Issa Z, Miller JM, Zipes DP(2009). Approach to Wide QRS Complex Tachycardias. Arrhythmology and Electrophysiology: A Companion to Braunwald's heart disease (1st ed., pp. 393). Philadelphia, Pa: Saunders Elsevier.
  4. ↑ 4.0 4.1 Zipes DP, Jalife J(2009). Cardiac electrophysiology: from cell to bedside (5th ed.). Philadelphia, Pa: Saunders Elsevier.
  5. ↑ Garson A, Gillette PC, McNamara DG (June 1981). "Supraventricular tachycardia in children: clinical features, response to treatment, and long-term follow-up in 217 patients". J. Pediatr. 98 (6): 875–82. doi:10.1016/s0022-3476(81)80578-1. PMID 7229788.


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