Sustained polymorphic arrhythmias induced by programmed ventricular stimulation have prognostic value in patients...

Area of Science:

• Cardiology
• Electrophysiology
• Sudden Cardiac Death Prevention

Background:

• Ischemic cardiomyopathy (ICM) patients with inducible monomorphic ventricular tachycardia (VT) face high sudden cardiac death (SCD) risk.
• The prognostic value of other induced ventricular arrhythmias (polymorphic VT, VF) in primary prevention is unclear.

Purpose of the Study:

• To compare outcomes in ICM patients undergoing primary prevention implantable cardioverter-defibrillator (ICD) implantation based on the type of ventricular arrhythmia induced during programmed ventricular stimulation (PVS).

Main Methods:

• Retrospective analysis of 105 ICM patients receiving ICDs for primary prevention.
• Patients were categorized into two groups: Group I (n=75) with inducible monomorphic VT, and Group II (n=30) with other sustained ventricular arrhythmias (ventricular flutter, fibrillation, polymorphic VT) induced by PVS.

Main Results:

• No significant difference in appropriate ICD therapy rates (21.3% vs. 20%) or survival free from ICD therapy between groups.
• Similar all-cause mortality after adjustment for ejection fraction and QRS duration.
• Baseline ejection fraction was lower and QRS duration longer in the monomorphic VT group.

Conclusions:

• The type of ventricular arrhythmia induced during PVS does not differentiate outcomes in ICM patients receiving ICDs for primary prevention.
• Inducible ventricular fibrillation or sustained polymorphic VT suggests similar risks of subsequent ventricular tachyarrhythmias as inducible monomorphic VT in this population.