Atrial and ventricular arrhythmias in patients with cardiac amyloidosis: Incidence, risk factors, and prognostic implications
Abstract
Methods
A single-center retrospective analysis was performed of consecutive patients diagnosed with or referred for
cardiac amyloidosis at our center from 2/2010–4/2023.
Results
A total of 186 patients were diagnosed with CA (AL-CA: 18.3%; ATTR-CA: 81.2%). Atrial fibrillation (AF) occurred in 61.8%, atrial flutter (AFL) in 24.7%, and sustained ventricular tachycardia (VT) in 6.5% of patients with CA. AF and AFL occurred more commonly in patients with ATTR-CA than AL-CA (AF: 66.9% vs 38.2%; p = 0.002; AFL: 28.5% vs 8.8%;
p = 0.017). On univariate analysis, QRS duration >120 ms (OR 4.22; 95% CI 1.21–14.64; p = 0.023) and left ventricular end diastolic diameter (OR 3.94; 95% CI 1.45–10.66;
p = 0.007) were associated with the development of sustained VT in patients with CA. Incidence of sustained VT in patients with CA was independently associated with increased risk of mortality (HR 2.22; 95% CI 1.10–4.50;
p = 0.027), however, ICD implantation was not associated with improved survival (HR 0.59; 95% CI 0.32–1.08;
p = 0.090).