Predictive value of ambulatory ECG monitoring for malignant arrhythmic events in genetic dilated cardiomyopathy
Dilated cardiomyopathy (DCM) can have different underlying causes, of which genetic causes are relatively common. This study looked at whether problems with the heart rhythm that are detected during 24-hour ECG monitoring could help predict dangerous heart rhythm events in patients with and without a genetic variant. It was performed to determine if 24-hour ECG monitoring is a necessary test for every patient with DCM. 354 patients, about one-third of whom had a genetic variant, were followed up for about eight years. Irregular heart rhythms were common in both groups but happened more often in people with genetic DCM. Permanent atrial fibrillation, episodes of very fast heartbeats from the atria, and short runs of fast beats from the ventricles called VT (ventricular tachycardia) were more frequent in the genetic group. Importantly, the rhythm problems seen on the 24-hour ECG were much better at predicting serious, potentially life-threatening heart rhythm events in people with genetic DCM than in those without a genetic cause. Adding other clinical information didn’t improve prediction much for the genetic group, meaning that information from the 24-hour ECG monitoring is very valuable. Overall, the study suggests that 24-hour ECG monitoring is especially valuable for identifying which patients with genetic DCM are at higher risk of dangerous heart rhythm complications but provides important information of the heart rhythm in all patients.
Venner MFGHM, Heymans ABM, Beelen NJ, Stroeks SLVM, Faassen IME, Sikking MA, Henkens MTHM, van der Crabben SN, Raafs AG, Heymans SRB, Verdonschot JAJ. Predictive value of ambulatory ECG monitoring for malignant arrhythmic events in genetic dilated cardiomyopathy.
Europace. 2025 Oct 31;27(11):euaf279. doi: 10.1093/europace/euaf279. PMID: 41206691; PMCID: PMC12619085.
Prepared by Job Verdonschot and Ruth Biller