Related Experiment Videos
Prognosis of patients with ventricular tachycardia or fibrillation and a normal electrophysiologic study
1Department of Medicine, Montefiore Medical Center/Moses Division, Albert Einstein College of Medicine, Bronx, NY 10467.
Insights
Noninducibility of ventricular tachycardia or fibrillation via programmed stimulation indicates preserved ventricular function. This finding suggests a low risk of sudden cardiac death in patients with preserved ejection fraction.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Arrhythmias
Background:
- Sustained ventricular arrhythmias like ventricular tachycardia and fibrillation pose a significant risk of sudden cardiac death.
- Programmed electrical stimulation is used to assess inducibility of these arrhythmias.
- The prognostic value of non-inducibility in patients with preserved ventricular function requires further clarification.
Purpose of the Study:
- To evaluate the outcome of patients with sustained ventricular tachycardia or fibrillation who were not inducible by baseline programmed stimulation.
- To determine the association between non-inducibility, ventricular function, and the risk of sudden cardiac death.
Main Methods:
- Retrospective study of 26 patients with sustained ventricular tachycardia (n=16) or ventricular fibrillation (n=10).
- Baseline programmed electrical stimulation was performed to assess ventricular arrhythmia inducibility.
- Ejection fraction and underlying cardiac conditions were recorded.
- Follow-up data on survival, sudden death, and total cardiac death were collected.
Main Results:
- The study included patients with coronary artery disease, dilated cardiomyopathy, valvular heart disease, or no apparent cardiac abnormalities.
- Mean left ventricular ejection fraction was 53% ± 14%.
- Actuarial survival rates at 1 and 2 years were high for both sudden death (95%, 89%) and total cardiac death (95%, 83%).
- No sudden cardiac deaths occurred in patients with an ejection fraction >30%.
Conclusions:
- Non-inducibility of ventricular arrhythmias by programmed stimulation in patients with sustained ventricular tachycardia or fibrillation is linked to preserved ventricular function.
- This non-inducibility may predict a low risk of sudden cardiac death, particularly in patients with preserved ventricular function.
Abstract:
The outcome of 26 patients with sustained ventricular tachycardia (n = 16) or ventricular fibrillation (n = 10) and no inducible ventricular tachycardia (less than or equal to 10 beats) by baseline programmed stimulation was studied. Coronary artery disease was present in 14 patients, dilated cardiomyopathy was seen in seven, valvular heart disease was present in two, and no apparent cardiac abnormalities were found in three. The mean left ventricular ejection fraction was 53 +/- 14%. During the follow-up period of 24 +/- 16 months, actuarial survival rates at 1 and 2 years were 95% and 89% for sudden death and 95% and 83% for total cardiac death, respectively. No patients with a known ejection fraction greater than 30% died suddenly during the follow-up. Noninducibility by programmed stimulation in patients with sustained ventricular tachycardia or fibrillation is associated with a relatively preserved ventricular function. It may predict a low risk of sudden death in patients with preserved ventricular function.