Evidence map›Paper›PMID 39882569›Full record

SynthesisOpen heart2024

Sudden cardiac death after acute myocarditis with arrhythmic presentation: hunting for risk predictors - a systematic review and meta-analysis.

Maria Lucia Narducci, Federico Ballacci, Federica Giordano, Valentino Collini, Massimo Imazio

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Open heart, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Incidence and predictors of major arrhythmic events after myocarditis: a systematic review and meta-analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Article
  6. Arrhythmic risk in acute myocarditis: Early threats, late events, and clinical uncertainty.International journal of cardiology. Heart & vasculature · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Maria Lucia NarducciDepartment of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.ORCID 0000-0001-8682-0322
Federico Ballacci *Cardiothoracic Department, Santa Maria della Misericordia University Hospital, Udine, Italy.ORCID 0000-0002-0341-1142
Federica Giordano *Cardiothoracic Department, Santa Maria della Misericordia University Hospital, Udine, Italy.ORCID 0000-0001-5479-5847
Valentino ColliniCardiothoracic Department, Santa Maria della Misericordia University Hospital, Udine, Italy.ORCID 0000-0003-0008-4630
Massimo ImazioCardiothoracic Department, Santa Maria della Misericordia University Hospital, Udine, Italy massimo.imazio@uniud.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVentricular arrhythmias (VAs) frequently occur in the acute phase of myocarditis. Possible arrhythmic recurrences and the risk of sudden cardiac death (SCD) in this setting are reasons for concern, and limited data have been published to guide clinical management of these patients. The aim of the present paper is to report the incidence of major arrhythmic events, defined as sustained VA, SCD and appropriate implantable cardiac-defibrillator (ICD) treatment, in patients with acute myocarditis and ventricular arrhythmic phenotype.

methodsWe conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to evaluate studies reporting long-term outcomes in patients with acute myocarditis and arrhythmic presentation. We systematically searched PubMed, EMBASE and Scopus databases for relevant studies up to 2 August 2024. Study quality was assessed by the Newcastle-Ottawa Scale. The primary outcome was a composite of SCD, VA recurrence and appropriate ICD therapy. Random-effect models were used to calculate pooled ORs and CIs.

resultsFive observational studies enrolling 322 patients were identified. The pooled proportion of patients who experienced VA recurrence was 0.41 (95% CI 0.30 to 0.53, p=0.13). An increased risk of adverse outcomes during follow-up was observed in patients presenting with monomorphic ventricular tachycardia (OR 3.77, 95% CI 1.23 to 11.53) and left ventricular ejection fraction (LVEF) <50% (OR 2.74, 95% CI 0.78 to 9.63). Gender and anteroseptal late gadolinium enhancement were not found as potential risk factors in this analysis.

conclusionsPatients with myocarditis with arrhythmic ventricular presentation have a high recurrence rate of VA, underscoring the importance of careful monitoring and management in this patient population. Risk stratification for SCD during follow-up should be individualised, and monomorphic VA at presentation or a reduced LVEF may be markers of poor prognosis. In these cases, an ICD implantation may be cautious pending further dedicated studies.

Indexed as

Arrhythmias, CardiacDeath, Sudden, CardiacMyocarditisTachycardia, VentricularAcute DiseaseDefibrillators, ImplantableGlobal HealthHumansIncidenceRecurrenceRisk AssessmentRisk FactorsArrhythmias, CardiacDeath, Sudden, CardiacDefibrillators, ImplantableMeta-AnalysisMyocarditis

Identifiers

PMID39882569
PMCPMC11603706

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.