Circadian and Seasonal Pattern of Arrhythmic Events in Arrhythmogenic Cardiomyopathy Patients

Silvia Castelletti (), Michele Orini, Annina S. Vischer, William J. McKenna, Pier D. Lambiase, Antonios Pantazis and Lia Crotti ()
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Silvia Castelletti: Istituto Auxologico Italiano, IRCCS, Department of Cardiology, Piazzale Brescia 20, 20149 Milan, Italy
Michele Orini: Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK
Annina S. Vischer: Medical Outpatient Department, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland
William J. McKenna: Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK
Pier D. Lambiase: Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK
Antonios Pantazis: National Heart and Lung Institute, Imperial College London, London SW7 2BX, UK
Lia Crotti: Istituto Auxologico Italiano, IRCCS, Department of Cardiology, Piazzale Brescia 20, 20149 Milan, Italy

IJERPH, 2023, vol. 20, issue 4, 1-13

Abstract: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiac disease associated with an increased risk of life-threatening arrhythmias. The aim of the present study was to evaluate the association of ventricular arrhythmias (VA) with circadian and seasonal variation in ARVC. One hundred two ARVC patients with an implantable cardioverter defibrillator (ICD) were enrolled in the study. Arrhythmic events included (a) any initial ventricular tachycardia (VT) or fibrillation (VF) prompting ICD implantation, (b) any VT or non-sustained VT (NSVT) recorded by the ICD, and (c) appropriate ICD shocks/therapy. Differences in the annual incidence of events across seasons (winter, spring, summer, autumn) and period of the day (night, morning, afternoon, evening) were assessed both for all cardiac events and major arrhythmic events. In total, 67 events prior to implantation and 263 ICD events were recorded. These included 135 major (58 ICD therapies, 57 self-terminating VT, 20 sustained VT) and 148 minor (NSVT) events. A significant increase in the frequency of events was observed in the afternoon versus in the nights and mornings ( p = 0.016). The lowest number of events was registered in the summer, with a peak in the winter ( p < 0.001). Results were also confirmed when excluding NSVT. Arrhythmic events in ARVC follow a seasonal variation and a circadian rhythm. They are more prevalent in the late afternoon, the most active period of the day, and in the winter, supporting the role of physical activity and inflammation as triggers of events.

Keywords: arrhythmia; sudden death; circadian; daily; seasonal; arrhythmogenic cardiomyopathy; implantable cardioverter defibrillator; ventricular tachycardia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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