[Mortality following sustained ventricular tachycardia treated according to the results of programmed ventricular...

The purpose of this study was to evaluate longterm mortality in 44 patients undergoing electrophysiologically guided therapy for sustained monomorphic ventricular tachycardia. We applied the following modified response criteria: non-inducibility or slowing of induced ventricular tachycardia to < or = 150 bpm. On this basis, 25/44 (57%) patients were classified as responders, and 19/44 (43%) as non-responders. Responders had palpitations significantly more often as the leading clinical sign (68% vs. 21%, p < 0.05). Non-responders showed a lower mean ejection fraction (36 +/- 15% vs. 46 +/- 17%, p < 0.05) and a trend to higher incidence of syncopal ventricular tachycardia (58% vs. 12%, p = 0.15). All responders and 3/19 non-responders continued on drug therapy. 11 non-responders received an implantable cardioverter-defibrillator (ICD), 3 underwent surgery and 2 catheter ablation. 14/44 patients (32%) died during a mean follow-up of 3.2 years. Sudden arrhythmic death occurred in 3/28 patients on drug therapy (1/25 responders, 2/3 non-responders), and in 2/16 non-responders with invasive therapy (one with an ICD and one after catheter ablation). The cumulative all-cause mortality at 3 years was similar in both groups (26% vs 22%, n.s.), but the mortality from sudden arrhythmic death showed a trend to be lower in the responder-group (0% vs 17%, p = 0.09).(ABSTRACT TRUNCATED AT 250 WORDS)