Prognosis of patients with ventricular tachycardia and ventricular fibrillation: role of the underlying etiology.
The prognosis of 149 patients with ventricular tachycardia (n = 108) or ventricular fibrillation (n = 41) was analyzed to assess the importance of the underlying etiology of the arrhythmia. Seventy-three patients (Group I) had a previous myocardial infarction and documented late sustained monomorphic ventricular tachycardia. Thirty-five (Group II) also had a previous myocardial infarction but had late ventricular fibrillation. There were 41 patients (Group III) without coronary artery disease: 9 patients with right ventricular dysplasia, 26 with idiopathic sustained ventricular tachycardia and 6 with idiopathic ventricular fibrillation. The mean follow-up period for all patients was 22 to 57 months. The total mortality rate in Group I (16%) and Group II (34%) and the arrhythmic mortality rate in Group I (5%) and Group II (11%) were significantly higher than the rates in Group III. In the latter group the total mortality rate was 4% for those with idiopathic ventricular tachycardia and 11% for those with right ventricular dysplasia, and there were no deaths due to arrhythmia (p less than 0.05). Left ventricular ejection fraction was significantly lower and left ventricular end-diastolic pressure was significantly higher in Group I and Group II than in Group III. There were nonfatal recurrences of ventricular tachycardia in 33 to 56% of patients, and the number of these episodes did not differ significantly in those with and without coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS)
Trappe
H J
HJ
Department of Cardiology, Academic Hospital Maastricht, The Netherlands.
Brugada
P
P
Talajic
M
M
Della Bella
P
P
Lezaun
R
R
Mulleneers
R
R
Wellens
H J
HJ
D000368:Aged; D002304:Cardiac Pacing, Artificial; D017023:Coronary Angiography; D003645:Death, Sudden / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011379:Prognosis; D012008:Recurrence; D013610:Tachycardia / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D014693:Ventricular Fibrillation / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology