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June 27, 2026EP EuropaceOpen Access

Malignant ventricular tachycardia was documented immediately prior to death in 124 patients (42%), occurring more frequently in patients with ICDs than in those with pacemakers (53% vs. 39%; p = 0.03).

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Population

296 patients with cardiac implantable electronic devices who died outside a healthcare facility and…

Design

Cohort

Authors

MVM ValekISI SotolovaDBD Brabcova

Discussion

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Overview

Highlights frequent malignant VT in device patients; leaves open its prognostic impact pending higher-level evidence.

Key Points

  • To assess the incidence and characteristics of malignant ventricular arrhythmias in patients with CIEDs just before death.
  • Analyzed data from 296 patients with CIEDs who died outside healthcare facilities and underwent autopsy.
  • Evaluated reports from emergency medical services, coroners, and device interrogations.
  • Collected data from eight forensic medicine departments.
  • Malignant ventricular tachycardia recorded in 124 patients (42% incidence).
  • Occurrence was higher in ICD patients (53%) compared to pacemaker patients (39%; p = 0.03).
  • For 74% of patients, malignant arrhythmia was likely the primary cause of death.

Structured PICO

P
Population
296 patients with cardiac implantable electronic devices (CIEDs) (94 with implantable cardioverter-defibrillators [ICDs] and 202 with pacemakers; mean age 75 ± 12 years; 72% male) who died outside a healthcare facility and underwent autopsy.
O
Outcome
Incidence and characteristics of malignant ventricular arrhythmias occurring immediately before death.hard clinical

Malignant ventricular arrhythmias occur in nearly half of CIED patients immediately prior to out-of-hospital death, often serving as the primary cause of sudden death.

Cite This Study

Valek et al. (2026) studied this question.

synapsesocial.com/papers/6a3f97bb125782b61d865927https://doi.org/10.1093/europace/euag105.1040
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Postmortem interrogation of cardiac implantable electronic devices - results from a large prospective registry2026
  2. 2Clinical Implications of an Implantable Cardioverter-Defibrillator in Patients With Vasospastic Angina and Lethal Ventricular Arrhythmia2012 · 124 citations
  3. 3Occult Idiopathic Ventricular Fibrillation After Preoperative Cardiovascular Evaluation2026
  4. 4Incessant Ventricular Fibrillation in a Patient with a Left Ventricular Assist Device and an Implantable Cardioverter-Defibrillator: A Case Report2026
  5. 5A Case of Focal Atrial Tachycardia Not Detected by the Implanted Device2025