Vericiguat therapy reduces arrhythmic events in patients with heart failure and cardiac implantable electronic devices

Atrial and ventricular arrhythmias (AAs and VAs) are frequently encountered in patients with heart failure (HF), increasing the risk of adverse cardiovascular (CV) outcomes, such as HFrelated hospitalization and CV death. The 4 pillars of guideline-directed medical therapy (GDMT) for HF consistently reduced AAs and VAs.1 Vericiguat, a guanylate cyclase stimulator, significantly reduced HF-related hospitalization and CV death in patients with HF with reduced ejection fraction (HFrEF) in the Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction trial2 and has been proposed as the fifth pillar of HF therapy. However, the antiarrhythmic effect of vericiguat has not been demonstrated. Herein, we evaluated AAs and VAs in patients with HFrEF and implantable cardioverter-defibrillators (ICDs) or cardiac resynchronization therapy with defibrillators (CRT-Ds) followed by remote monitoring.