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Sequelae of nonsustained polymorphic ventricular tachycardia induced during programmed ventricular stimulation.
W H Kou1, M de Buitleir, A H Kadish
1Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor.
The American Journal of Cardiology
|November 15, 1989
Summary
Nonsustained polymorphic ventricular tachycardia (VT) induced during electrophysiology studies does not reliably predict sustained VT. Using it as a stopping point may increase specificity but reduce the detection of monomorphic VT.
Area of Science:
- Electrophysiology
- Cardiology
Background:
- Programmed ventricular stimulation (PVS) is used to evaluate arrhythmias.
- Nonsustained polymorphic ventricular tachycardia (VT) can be induced during PVS.
Purpose of the Study:
- To determine the significance of nonsustained polymorphic VT during PVS.
- To assess its predictive value for sustained VT induction.
Main Methods:
- Prospective analysis of 206 PVS studies in 130 patients.
- Standard pacing protocols with up to 3 extrastimuli were used.
- Induction of nonsustained and sustained monomorphic and polymorphic VT was recorded.
Main Results:
- Nonsustained polymorphic VT preceded sustained polymorphic VT more often than sustained monomorphic VT (72% vs. 44%).
- Overall, sustained monomorphic VT was induced in 110 studies, sustained polymorphic VT in 18.
- Nonsustained polymorphic VT was induced in 111 studies.
Conclusions:
- Nonsustained polymorphic VT is not a useful predictor of PVS outcomes.
- Using nonsustained polymorphic VT as an endpoint may improve specificity but decrease monomorphic VT yield.