Holter monitoring in AL amyloidosis: Prognostic implications

Giovanni Palladini, Giandomenico Malamani, Francesca Cò., Angela Pistorio, Franco Recusani, Ernesto Anesi, Pietro Garini, Giampaolo Merlini

Research output: Contribution to journalArticlepeer-review

Abstract

The heart is involved in more than one third of patients with primary (AL) amyloidosis at diagnosis and it is by far the most common cause of death. Rhythm and conduction abnormalities generally represent the terminal event. The aims of this study were to determine the spectrum of Holter abnormalities found in AL amyloidosis and to assess their prognostic significance, particularly in relation to sudden death. Fifty-one patients with AL amyloidosis were included, and all of them had a complete history, physical examination, two-dimensional echocardiography, and 24-hour Holter monitoring. Fifty-five percent of these patients had echographic signs of heart involvement and 23% had heart failure. Complex ventricular arrhythmias were found in 57% of patients, couplets in 29%, and nonsustained ventricular tachycardia in 18%. Overall median survival was 23.4 months. Congestive heart failure, echocardiographic abnormalities, and Holter abnormalities adversely affected survival. The multivariate analysis demonstrated that interventricular septum thickness and couplets were independent predictors of survival. The presence of couplets correlated with sudden death. Holter monitoring may contribute to assessing the prognosis of patients with AL amyloidosis.

Original languageEnglish
Pages (from-to)1228-1233
Number of pages6
JournalPACE - Pacing and Clinical Electrophysiology
Volume24
Issue number8
Publication statusPublished - 2001

Keywords

  • Amyloidosis
  • Arrhythmia
  • Echocardiography
  • Holter monitoring
  • Prognosis
  • Sudden death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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