Limitations
NSVT, PPCM, non-ischaemic cardiomyopathy, arrhythmias, heart failure
NON-ISCHAEMIC CARDIOMYOPATHY, RARE DISEASE, VENTRICULAR ARRHYTHMIA, ARRHYTHMIAS, HEART FAILURE
We acknowledge that the patient cohort included in this study is small, and do not allow for definitive recommendations. However, PPCM is a relatively rare disease. The sample size might have affected the estimate of the true prevalence of arrhythmias in patients with newly diagnosed PPCM. As only ten patients received an ILR (which allows for continuous rhythm monitoring), we cannot comment on subsequent arrhythmias in patients who only received 24 h-Holter ECG monitoring.Our study is also not adequately powered to answer the question about which patients are most likely to benefit from ILR, but patients with severely reduced LV function or severe symptoms of heart failure appeared to be at higher risk for ventricular arrhythmias. Therefore, as recommended by the latest ESC position statement on PPCM [Our sample size is also too small to answer the question whether patients with short runs of NSVT have a higher risk of SCD. However, it may be a surrogate marker of a more severely diseased ventricle. The detection of NSVT is important, because it has previously been reported to be a marker of increased risk of SCD in patients with non-ischaemic cardiomyopathy [In this study, we used the out of the box settings for the detection of VAs by ILR, as most physicians would do in clinical practice. It is possible this underestimated the frequency of shorter NSVT episodes. However, considering only NSVT of more than 16 consecutive beats on Holter, would have decreased the detection rate by Holter monitoring.A further limitation to this study is that Holter monitoring was only performed at the time of index diagnosis, and not at follow-up. This might have underestimated the true prevalence of arrhythmias in this cohort.We encourage validation of our findings in a larger, multi-centred cohort. However, to the best of our knowledge, this is the largest prospective study on extended electrocardiographic monitoring on consecutive women with PPCM regardless of their initial LVEF.