Association of Ventricular Arrhythmias with Dementia: The Atherosclerosis Risk in Communities (ARIC) Study.

OBJECTIVE -We performed a cross-sectional analysis to determine whether nonsustained ventricular tachycardia (NSVT) and premature ventricular contractions (PVCs) were associated with dementia in a population-based study. METHODS - We included 2517 (mean age 79; 26% black) participants who wore a 2-week ambulatory continuous ECG recording device in 2016-17. NSVT was defined as a wide complex tachycardia ≥ 4 beats with a rate >100 beats per minute. We calculated NSVT and PVC burden as the number of episodes per day. Dementia was adjudicated by experts. We used logistic regression to assess the associations of NSVT and PVCs with dementia. RESULTS - The mean recording time of the Zio® XT Patch was 12.6 ± 2.6 days. There were 768 (31%) participants with NSVT; prevalence was similar in whites and blacks. There were 134 (6.5%) dementia cases (5% in whites; 10% in blacks). After multivariable adjustment, there was no overall association between NSVT and dementia; however, there was a significant race interaction (p<0.001). In blacks, NSVT was associated with a 3.67 times higher adjusted odds of dementia (95% CI = 1.92-7.02) compared to those without NSVT, whereas in whites NSVT was not associated with dementia [OR (95% CI) = 0.64 (0.37-1.10)]. In blacks only, a higher burden of PVCs was associated with dementia. CONCLUSIONS - Presence of NSVT and a higher burden of NSVT and PVCs are associated with dementia in elderly blacks. Further research to confirm this novel finding and elucidate the underlying mechanisms is warranted.