Abstract 11898: Heart Failure With Preserved Ejection Fraction is a Highly Arrhythmogenic Disease

Introduction:Sudden cardiac death (SCD) is relatively common in patients with heart failure preserved ejection fraction (HFpEF). However, the spectrum and burden of various arrhythmias, including those of ventricular origin, is not well established in this population.Methods:We performed routine arrhythmia surveillancefor 14 days using an adhesive patch ambulatory ECG recorder (ZioPatch) in patients with HFpEF, enrolled in a subspecialty heart failure clinic. Cardiac electrophysiologists interpreted the ECG recordings. Relevant clinical data was extracted from electronic medical records.Results:A total of 40 patients (mean age 71.1?9.9 years, 53% women) with HFpEF underwent routineZiopatch monitoring. Mean ejection fraction (EF) was 59.4?4.4%, 44% had history of coronary artery disease. 32.5% of patients had episodes of non-sustained ventricular tachycardia (VT) (mean 5?5.2 episodes), 15.0% had paroxysmal atrial fibrillation and 80.0% had episodes of supraventricular tachycardia during the monitored period. All patients had premature ventricular complexes (PVC) with 7.5% having a PVC burden that exceeded 5%. Patients with non-sustained VT had a relatively lower EF, higher Nt-proBNP level and were more likely to be obese (Table 1).Conclusion:The high arrhythmia burden in patients with HFpEF may be underappreciated and undertreated. In addition, the frequent episodes of ventricular arrhythmias may provide insight into the mechanism of SCD in this population