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Article

Circadian and Seasonal Pattern of Arrhythmic Events in Arrhythmogenic Cardiomyopathy Patients

by
Silvia Castelletti
1,*,
Michele Orini
2,
Annina S. Vischer
3,4,
William J. McKenna
2,5,
Pier D. Lambiase
2,6,
Antonios Pantazis
7,8 and
Lia Crotti
1,9,*
1
Istituto Auxologico Italiano, IRCCS, Department of Cardiology, Piazzale Brescia 20, 20149 Milan, Italy
2
Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK
3
Medical Outpatient Department, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland
4
Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
5
Department of Cardiology, University of A Coruña, 15001 A Coruña, Spain
6
The Barts Heart Centre, Barts Health NHS Trust, London E1 1BB, UK
7
National Heart and Lung Institute, Imperial College London, London SW7 2BX, UK
8
Cardiovascular Research Centre, Royal Brompton and Harefield Hospitals, London SW3 6NP, UK
9
Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
*
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2023, 20(4), 2872; https://doi.org/10.3390/ijerph20042872
Submission received: 19 December 2022 / Revised: 22 January 2023 / Accepted: 28 January 2023 / Published: 7 February 2023
(This article belongs to the Special Issue Critical Issue on Heart Disease and Health)
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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 arrhythmia; sudden death; circadian; daily; seasonal; arrhythmogenic cardiomyopathy; implantable cardioverter defibrillator; ventricular tachycardia
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MDPI and ACS Style

Castelletti, S.; Orini, M.; Vischer, A.S.; McKenna, W.J.; Lambiase, P.D.; Pantazis, A.; Crotti, L. Circadian and Seasonal Pattern of Arrhythmic Events in Arrhythmogenic Cardiomyopathy Patients. Int. J. Environ. Res. Public Health 2023, 20, 2872. https://doi.org/10.3390/ijerph20042872

AMA Style

Castelletti S, Orini M, Vischer AS, McKenna WJ, Lambiase PD, Pantazis A, Crotti L. Circadian and Seasonal Pattern of Arrhythmic Events in Arrhythmogenic Cardiomyopathy Patients. International Journal of Environmental Research and Public Health. 2023; 20(4):2872. https://doi.org/10.3390/ijerph20042872

Chicago/Turabian Style

Castelletti, Silvia, Michele Orini, Annina S. Vischer, William J. McKenna, Pier D. Lambiase, Antonios Pantazis, and Lia Crotti. 2023. "Circadian and Seasonal Pattern of Arrhythmic Events in Arrhythmogenic Cardiomyopathy Patients" International Journal of Environmental Research and Public Health 20, no. 4: 2872. https://doi.org/10.3390/ijerph20042872

APA Style

Castelletti, S., Orini, M., Vischer, A. S., McKenna, W. J., Lambiase, P. D., Pantazis, A., & Crotti, L. (2023). Circadian and Seasonal Pattern of Arrhythmic Events in Arrhythmogenic Cardiomyopathy Patients. International Journal of Environmental Research and Public Health, 20(4), 2872. https://doi.org/10.3390/ijerph20042872

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