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Bedside programmed ventricular stimulation for sudden death risk stratification.
Abdel J Fuenmayor1, César Landaeta, Félix Peraza
1Clinical Electrophysiology Section, Cardiovascular Research Institute, University of The Andes, Apartado Postal 154, Mérida 5101, Venezuela. farocha@ula.ve
International Journal of Cardiology
|September 1, 2004
Summary
Bedside programmed stimulation safely identifies high-risk myocardial infarction patients for sudden death. This cost-effective method aids in stratifying risk and guiding treatment, improving patient outcomes.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Patients with myocardial infarction (MI) and left ventricular dysfunction face a significant risk of sudden cardiac death.
- Risk stratification is crucial for identifying these vulnerable individuals.
Purpose of the Study:
- To evaluate the safety and applicability of a bedside programmed stimulation protocol.
- To determine its utility in assessing sudden death risk in post-MI patients.
Main Methods:
- Echocardiography and Holter monitoring assessed left ventricular ejection fraction, arrhythmia, late potentials, and heart rate variability in 412 MI patients.
- Fifty high-risk patients underwent bedside programmed ventricular stimulation via a right ventricular catheter under fluoroscopy and ECG monitoring.
- Patients were followed for in-hospital morbidity and mortality.
Main Results:
- The programmed stimulation procedure was safe, with no complications reported.
- Ventricular tachycardia or fibrillation was induced in six patients, who were treated with amiodarone and/or defibrillator implantation.
- During a 22-month follow-up, implanted devices appropriately discharged in five patients, and no arrhythmic sudden deaths occurred.
Conclusions:
- Bedside programmed stimulation is a safe and effective tool for sudden death risk stratification in post-MI patients.
- This method is more cost-effective than conventional procedures.