Biomarkers for prediction of ventricular arrhythmias

Abstract

Ventricular arrhythmias are life-threatening cardiac arrhythmias that can lead to circulatory collapse and sudden cardiac death. Implantation of a cardiac defibrillator is recommended to prevent sudden cardiac death in patients who are at high risk of such severe arrhythmic events. However, there are currently no accurate tools that enable prediction of patients at increased risk. Therefore, we aimed to assess the value of cardiovascular markers for the prediction of ventricular arrhythmias in a high-risk population. First, we demonstrate that patients who had inhomogeneity in the electrical signal of the ventricular pumping phase of the cardiac cycle (i.e. fragmentation of the QRS complex on ECG) had over 3 times higher risk of ventricular arrhythmias compared to those who did not have QRS fragmentation. Second, we demonstrate that higher levels of the established cardiovascular biomarkers troponin and NT-proBNP were associated with an increased risk of ventricular arrhythmias. In contrast, there were no association between biomarkers of inflammation ventricular arrhythmia risk. These findings suggest that QRS-fragmentation, troponin and NT-proBNP may be useful markers for selecting patients who will benefit from treatment with an implantable cardioverter defibrillator.