Right ventricular dysfunction: an overlooked predictor of sudden cardiac death and arrhythmic events-a meta-analysis.
Toshinori Chiba, Amelie Beblo, Nora Wainstejn et al.
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In 30 seconds
This systematic review and random-effects meta-analysis assessed whether right ventricular (RV) dysfunction predicts sudden cardiac death (SCD) or severe ventricular arrhythmias (VAs). Seven studies involving 1475 patients were included, with a mean follow-up of 2.9 years. RV dysfunction was associated with higher odds of SCD or VA (OR 3.69; 95% CI 2.40-5.66; p < 0.01). Patients with events also had lower RV fractional area change, while left ventricular ejection fraction did not differ significantly. The findings support the prognostic relevance of RV measures, but do not establish that RV dysfunction causes arrhythmic events.
Key findings
- RV dysfunction was associated with SCD or severe VA (OR 3.69; 95% CI 2.40-5.66; p < 0.01).
- Patients with SCD or VA had lower RVFAC than those without events (MD - 5.67; 95% CI - 8.73 to - 2.60; p < 0.01).
- LVEF did not differ significantly between patients with and without events (MD - 0.59; 95% CI - 4.10 to 2.92; p = 0.74).
Why it matters
Arrhythmic risk assessment often focuses on left ventricular function, but this synthesis links RV dysfunction with SCD and severe VA. Considering RV measures alongside other clinical information may help characterize risk more fully. The evidence is prognostic and associative; it does not show that RV dysfunction causes events or that using RV measures to guide care improves outcomes.
What to keep in mind
The meta-analysis included only seven studies and 1475 patients; the abstract does not report study-level design details or establish that RV measures improve outcomes when used to guide care.