Implantable loop recording in patients with heart failure and preserved ejection fraction

  • Area: Cardiology
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On June 12th 2020 at the HFA Discoveries, the Ventricular Tachyarrhythmia Detection by Implantable Loop Recording in Patients with Heart Failure and Preserved Ejection Fraction (VIP-HF) study was presented by Gijs van Woerden and Michiel Rienstra.
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The VIP-HF study was designed to examine the incidence of sustained ventricular tachyarrhythmias in patients with heart failure with preserved- or mildly reduced ejection fraction. For this purpose, patients were implanted with an implantable loop recorder. This device is placed under the skin, and can record the heart rhythm continuously for up to two years. In addition, prior to implantation of the loop recorder, patients underwent extensive phenotyping, including cardiac magnetic resonance imaging, 24h-Holter monitoring and laboratory testing.

Primary endpoint

Remarkably, the primary endpoint of sustained ventricular tachyarrhythmias was observed in only 1 patient (0.6 events per 100 person years) during a median of 1.8 years of follow-up. In contrast; bradyarrythmias were more observed, namely in 5 patients (3.2 events per 100 person years), of whom 3 needed pacemaker therapy. Overall hospitalisations for heart failure and mortality were high (16.3 and 8.7 events per 100 person years, respectively.)

Low incidence

The VIP-HF study reports a low incidence of sustained ventricular tachyarrhythmias in patients with heart failure with preserved- or mildly reduced ejection fraction, 10-times lower than anticipated. In contrast, clinically relevant bradyarrhythmias were more often observed than expected.