{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:24:15Z","timestamp":1791300255022,"version":"4.1.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T00:00:00Z","timestamp":1701734400000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Clinical features and risk stratification of patients with viral myocarditis (VM) complicated by ventricular arrhythmias (VA) are incompletely understood. We aim to describe arrhythmia patterns and outcomes in patients with VM and early-onset VA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We present a single-centre study, enrolling patients with VM proven by endomyocardial biopsy, and evidence of VA within 24\u2005h of hospitalization. The incidence of major adverse events (MAE), including all-cause death, severe heart failure, advanced atrioventricular blocks, or major VA, was evaluated during a 24-month follow-up (FU) and compared with a matched group of virus-negative myocarditis. Of patients with VM (n = 74, mean age 47 \u00b1 16 years, 66% males, and left ventricular ejection fraction 51 \u00b1 13%), 20 (27%) presented with major VA [ventricular tachycardia\/ventricular fibrillation (VT\/VF)], and 32 (44%) had polymorphic VA. Patients with polymorphic VA more commonly had evidence of ongoing systemic infection (24\/32 vs. 10\/42, P = 0.004) and experienced greater occurrence of MAE at discharge (15\/32 vs. 2\/42, P &amp;lt; 0.001). However, the incidence of MAE during FU was higher in patients with monomorphic VA compared to those with polymorphic VA (17\/42 vs. 2\/28, P = 0.002). Patients with monomorphic VA displayed frequently signs of chronic cardiomyopathy and had outcomes comparable with virus-negative myocarditis (log rank P = 0.929). Presentation with VT\/VF was independently associated with MAE [at discharge: hazard ratio (HR) 4.7, 95% confidence interval (CI) 1.6\u201314.0, P = 0.005; during FU: HR 6.3, 95% CI 2.3\u201317.6, P &amp;lt; 0.001].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In patients with VM, polymorphic VA point to ongoing systemic infection and early adverse outcomes, whereas monomorphic VA suggest chronic cardiomyopathy and greater incidence of MAE during FU. Presentation with VT\/VF is independently associated with MAE.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjopen\/oead132","type":"journal-article","created":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T20:58:41Z","timestamp":1701809921000},"source":"Crossref","is-referenced-by-count":16,"title":["Clinical profiling and outcomes of viral myocarditis manifesting with ventricular arrhythmias"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1815-4000","authenticated-orcid":false,"given":"Giovanni","family":"Peretto","sequence":"first","affiliation":[{"name":"Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute , Via Olgettina 60, 20132 Milan , Italy"},{"name":"Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute , Via Olgettina 60, 20132 Milan , Italy"},{"name":"School of Medicine, Vita-Salute San Raffaele University , Via Olgettina 60 , 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3303-8892","authenticated-orcid":false,"given":"Simone","family":"Sala","sequence":"additional","affiliation":[{"name":"Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute , Via Olgettina 60, 20132 Milan , Italy"},{"name":"Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute , Via Olgettina 60, 20132 Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Carturan","sequence":"additional","affiliation":[{"name":"Cardiovascular Pathology, Department of Cardio-Thoracic-Vascular Sciences & Public Health and Azienda Ospedaliera, University of Padua Medical School , Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Cardiovascular Pathology, Department of Cardio-Thoracic-Vascular Sciences & Public Health and Azienda Ospedaliera, University of Padua Medical School , Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Villatore","sequence":"additional","affiliation":[{"name":"Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute , Via Olgettina 60, 20132 Milan , Italy"},{"name":"School of Medicine, Vita-Salute San Raffaele University , Via Olgettina 60 , 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5306-7714","authenticated-orcid":false,"given":"Giacomo","family":"De Luca","sequence":"additional","affiliation":[{"name":"Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute , Via Olgettina 60, 20132 Milan , Italy"},{"name":"School of Medicine, Vita-Salute San Raffaele University , Via Olgettina 60 , 20132 Milan, Italy"},{"name":"Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6806-3794","authenticated-orcid":false,"given":"Corrado","family":"Campochiaro","sequence":"additional","affiliation":[{"name":"Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute , Via Olgettina 60, 20132 Milan , Italy"},{"name":"School of Medicine, Vita-Salute San Raffaele University , Via Olgettina 60 , 20132 Milan, Italy"},{"name":"Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1564-2060","authenticated-orcid":false,"given":"Anna","family":"Palmisano","sequence":"additional","affiliation":[{"name":"Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute , Via Olgettina 60, 20132 Milan , Italy"},{"name":"School of Medicine, Vita-Salute San Raffaele University , Via Olgettina 60 , 20132 Milan, Italy"},{"name":"Experimental Imaging Center, Radiology Unit, IRCCS San Raffaele Scientific Institute , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2692-7432","authenticated-orcid":false,"given":"Davide","family":"Vignale","sequence":"additional","affiliation":[{"name":"Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute , Via Olgettina 60, 20132 Milan , Italy"},{"name":"Experimental Imaging Center, Radiology Unit, IRCCS San Raffaele Scientific Institute , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-4883","authenticated-orcid":false,"given":"Monica","family":"De Gaspari","sequence":"additional","affiliation":[{"name":"Cardiovascular Pathology, Department of Cardio-Thoracic-Vascular Sciences & Public Health and Azienda Ospedaliera, University of Padua Medical School , Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Dagna","sequence":"additional","affiliation":[{"name":"School of Medicine, Vita-Salute San Raffaele University , Via Olgettina 60 , 20132 Milan, Italy"},{"name":"Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Esposito","sequence":"additional","affiliation":[{"name":"Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute , Via Olgettina 60, 20132 Milan , Italy"},{"name":"School of Medicine, Vita-Salute San Raffaele University , Via Olgettina 60 , 20132 Milan, Italy"},{"name":"Experimental Imaging Center, Radiology Unit, IRCCS San Raffaele Scientific Institute , Milan , 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