Stroke and TIA were identified by imaging report and diagnosis at the time of discharge. New-onset systolic HF and new-onset AF were identified and validated by echocardiographic result and ECG report. Hospitalization was defined as an overnight stay in a hospital ward. Primary and secondary endpoints were investigated in detail based on initial identification through International Classification of Diseases, Ninth Edition (ICD-9), with reference to diagnostic codes or mention of an endpoint on discharge summary, and the database of the CCHIA and NHIRD which had been previously validated. The secondary endpoints were events of all-cause hospitalization, hospitalization for CV-related conditions, new-onset AF (atrial fibrillation), ischemic stroke, transient ischemic attack (TIA), and new-onset HF. The primary endpoint of this study was all-cause mortality. Follow-up data of all participants was retrieved from Taipei Veterans General Hospital, Taiwan National Health Insurance Research Database (NHIRD) and CCHIA. Alternatively, those patients without regular medication were followed-up based on physician decision or after a new event as defined in this study. Patients with regular medication received scheduled follow-up every 1–3 months depending upon their clinical course. Furthermore, the Institutional Review Board at Taipei Veterans General Hospital, Taipei, Taiwan approved this study (VGH-IRB Number: 2013-08- 002AC#1). This methodology has been validated in our previous studies.
The final sample included 3767 patients for analysis. The exclusion criteria in our study were as follows: participants with prevalent sustained ventricular tachycardia, permanent pacemaker, heart failure (HF), previous myocardial infarction, catheter ablation, pulmonary hypertension or hypertrophic cardiomyopathy, and valvular heart disease. Clinical features for these patients, including past medical history, comorbidities, and medications, were obtained from hospital discharge diagnoses, outpatient visits, emergency visits, and the Collaboration Center of Health Information Application (CCHIA), Ministry of Health and Welfare in Taiwan. The extent of clinical follow-up for each patient was determined by physician decision. A total of 5903 patients were referred for 24-hour electrocardiography (ECG) monitoring between Januand Decemfor the following indications: palpitations, syncope, and suspected arrhythmia hospitalized patients were excluded from the study. This retrospective, observational study was based on the database of “ Registry of 24-hour ECG monitoring at Taip ei Veterans General Hospital” (REMOTE). The aim of our study was to evaluate the clinical importance of NSVT in the absence of apparent structural heart disease. These studies suggest that dyssynchronous ventricular contraction might play a role in thromboembolic events. Previous studies showed the association between ventricular arrhythmia and ischemic stroke. The role of NSVT in ischemic stroke is less well-studied, but remains a topic of interest to researchers. Yet the prognostic significance in trained athletes was also controversial in previous studies. During exercise or at the recovery phase, recent clinical studies have shown that NSVT could predict an increase in cardiovascular mortality. However, the prognostic significance of NSVT in structurally normal hearts has not yet been established.
Previous studies have suggested an association between NSVT and increased mortality. It has been ascertained that NSVT episodes can be recorded in a normal population. In general, NSVT is defined as 3 or more consecutive ventricular beats with an RR interval of 600 ms and lasting <30 second.
Non-sustained ventricular tachycardia (NSVT) is a common arrhythmia encountered in modern clinical cardiology.
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