ArticleJournal of geriatric cardiology : JGC2026
Circadian chaos of ventricular tachyarrhythmia: a novel digital phenotype predicts mortality in high-risk SCD patients.
Article in Journal of geriatric cardiology : JGC, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: While ventricular tachyarrhythmias (VTAs) exhibited circadian variation at the population level, the prognostic significance of individual VTA onset circadian patterns recorded via home monitoring in patients with high-risk SCD remains poorly defined. Methods: This secondary analysis of the SUMMIT registry retrospectively evaluated archived remote monitoring data. Patients were categorized into four groups based on the diurnal distribution of their VTA episodes: no VTA, daytime VTA (> 70% of episodes between 06: 00-21: 59), nocturnal VTA (> 70% between 22: 00-05: 59), and mixed VTA (no predominant pattern). Results: Among 756 included patients (mean follow-up 48.8 months), 443 (58.6%) experienced at least one VTA. Dominant daytime VTA onset occurred in 292 patients (65.9%), dominant nocturnal onset in 57 (12.9%), and mixed diurnal pattern in 94 (21.2%). The mixed VTA group had the highest mortality risks across four VTA groups, which demonstrated 4.4- and 2.5-fold higher risks of cardiac death (hazard ratio (HR): 4.42; 95% CI: 2.52-7.76; Conclusions: A mixed VTA circadian pattern, characterized by the absence of a dominant diurnal rhythm, is a strong, independent predictor of increased mortality in high-risk SCD patients, highlighting its value for risk stratification.
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