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Programmed ventricular stimulation for arrhythmia risk prediction in patients with idiopathic dilated cardiomyopathy

W Grimm1, J Hoffmann, V Menz

  • 1Department of Cardiology, Hospital of the Philipps-University of Marburg, Germany.

Journal of the American College of Cardiology
|September 19, 1998
PubMed

Insights

Programmed ventricular stimulation (PVS) did not effectively predict arrhythmia risk in patients with idiopathic dilated cardiomyopathy (IDC) and nonsustained ventricular tachycardia (VT). The study lacked sufficient power to rule out moderate outcome differences between patients with and without inducible VT.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • Nonsustained ventricular tachycardia (VT) in idiopathic dilated cardiomyopathy (IDC) is linked to increased sudden cardiac death risk.
  • Effective risk stratification is crucial for managing patients with IDC and spontaneous nonsustained VT.

Purpose of the Study:

  • To evaluate the utility of programmed ventricular stimulation (PVS) for predicting arrhythmia events in patients with IDC and nonsustained VT.
  • To assess the correlation between inducible sustained ventricular arrhythmias during PVS and subsequent arrhythmic events.

Main Methods:

  • 34 patients with IDC, reduced left ventricular ejection fraction (< or =35%), and spontaneous nonsustained VT underwent PVS.
  • Patients were prospectively followed for 24+/-13 months for arrhythmic events, including sudden cardiac death and ICD shocks.

Main Results:

  • Sustained ventricular arrhythmias were induced in 38% of patients (3% monomorphic VT, 29% polymorphic VT/ventricular fibrillation).
  • No significant difference in arrhythmic events was observed between patients with inducible (31%) and non-inducible (24%) sustained ventricular arrhythmias during follow-up.
  • Implantable cardioverter-defibrillators (ICDs) were implanted in all patients with inducible arrhythmias and 43% of those without.

Conclusions:

  • Programmed ventricular stimulation (PVS) does not appear to be a helpful tool for arrhythmia risk stratification in this patient cohort.
  • The study's limited sample size restricts definitive conclusions regarding PVS efficacy and the ability to exclude moderate outcome differences.
Abstract

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