[Mortality following sustained ventricular tachycardia treated according to the results of programmed ventricular stimulation].
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)
Chételat
C A
CA
Division de cardiologie, CHUV, Lausanne.
Fromer
M
M
Schläpfer
J
J
Kappenberger
L
L
D000328:Adult; D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D017115:Catheter Ablation; D017147:Defibrillators, Implantable; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013318:Stroke Volume; D016019:Survival Analysis; D013557:Switzerland / Q000453:epidemiology; D017180:Tachycardia, Ventricular / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*
Mortalité après tachycardie ventriculaire soutenue traitée selon les résultats de la stimulation ventriculaire programmée.