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Prognosis of patients with a first episode of sustained monomorphic ventricular tachycardia
A Bodegas1, J Arana, J R Rumoroso
1Department of Cardiology, Hospital de Cruces, Barakaldo, Basque Country, Spain.
Insights
Survival after a first episode of sustained monomorphic ventricular tachycardia (SMVT) depends on left ventricle ejection fraction (EF) and syncope. Low EF (<50%) significantly increases cardiac mortality risk in SMVT patients.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Sustained monomorphic ventricular tachycardia (SMVT) is a serious arrhythmia.
- Understanding prognostic factors is crucial for patient management.
Purpose of the Study:
- To evaluate cardiac mortality in patients experiencing their first episode of SMVT.
- To identify predictors of mortality following SMVT.
Main Methods:
- A cohort of 100 patients under 75 years old with a first SMVT episode were followed for 50 months.
- Patients were categorized by underlying cardiac condition (myocardial infarction, dilated cardiomyopathy, etc.).
- Ejection fraction (EF) and presence of syncope were key parameters analyzed.
Main Results:
- Cardiac mortality was significantly higher in patients with EF < 50% (38%) compared to EF >= 50% (5%).
- Patients experiencing syncope during the initial SMVT episode had higher mortality (31%) than those without (14%).
- A combination of syncope, myocardial infarction, and EF < 50% resulted in a 68% mortality rate.
Conclusions:
- Left ventricle ejection fraction (EF) and the presence of syncope are critical determinants of survival after a first SMVT episode.
- Patients with myocardial infarction and reduced EF (<50%) face a particularly poor prognosis, especially with inferior wall involvement.
Aims:
To evaluate the cardiac mortality in patients suffering from a first episode of sustained monomorphic ventricular tachycardia (SMVT).
Methods:
100 patients less than 75 years old were evaluated during a 50-month follow-up period. Patients were classified into four groups: myocardial infarction, dilated cardiomyopathy, normal heart and miscellany. Seventeen patients underwent a cardioverter-defibrillator implantation, two heart transplant, three aneurysmectomy and 10 other types of cardiac surgical proceedings.
Results:
Patients with a left ventricle ejection fraction (EF)> or =50% presented a cardiac mortality of 5% compared with 38% of those with EF<50%. Etiology of underlying cardiomyopathy with an EF> or =50% was associated with a cardiac mortality of 5% (normal heart), 5% (myocardial infarction) and 9% (miscellany) compared to those with EF<50%: 33% (dilated cardiomyopathy) and 40% (myocardial infarction). Patients who experienced syncope during the first episode of SMVT showed a cardiac mortality of 31% compared to those 14% (P < 0.05) who did not experience. Patients with syncope, myocardial infarction and EF<50% showed a cardiac mortality of 68%.
Conclusion:
The present study shows that survival after the first episode of SMVT is closely related to EF and the existence of syncope. Patients with myocardial infarction and EF<50% had a worse prognosis when the site was the inferior wall.