Nonsustained ventricular tachycardia in coronary artery disease: relation to inducible sustained ventricular tachycardia. MUSTT Investigators.
BACKGROUND
Many physicians believe that electrocardiographic characteristics of nonsustained ventricular tachycardia correlate with the risk for sudden death in survivors of myocardial infarction. Sustained ventricular tachycardia induced by programmed electrical stimulation has also been shown to predict sudden death.


OBJECTIVE
To determine whether electrocardiographic characteristics of spontaneous nonsustained ventricular tachycardia can predict the inducibility of sustained ventricular tachycardia by programmed electrical stimulation in patients with coronary artery disease having abnormal ventricular function.


METHODS
Observational cohort study.


METHODS
70 clinical electrophysiology laboratories in the United States and Canada.


METHODS
1480 consecutive patients with coronary artery disease, left ventricular ejection fraction of 0.40 or less, and asymptomatic nonsustained ventricular tachycardia.


METHODS
Electrophysiologic study attempting to induce sustained monomorphic ventricular tachycardia.


METHODS
Daily frequency, duration, and cycle length of spontaneous episodes of nonsustained ventricular tachycardia, measured by standard electrocardiographic recordings.


RESULTS
No statistically significant difference in the frequency or duration of spontaneous nonsustained ventricular tachycardia was seen between patients with and those without inducible sustained ventricular tachycardia. Rates of spontaneous tachycardia were slightly slower in patients with inducible ventricular tachycardia than in patients without inducible ventricular tachycardia (P = 0.047), but the difference was not clinically significant.


CONCLUSIONS
Electrocardiographic characteristics of spontaneous nonsustained ventricular tachycardia do not predict which patients with coronary artery disease will have inducible sustained ventricular tachycardia.
Buxton
A E
AE
Department of Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USA.
Lee
K L
KL
DiCarlo
L
L
Echt
D S
DS
Fisher
J D
JD
Greer
G S
GS
Josephson
M E
ME
Packer
D
D
Prystowsky
E N
EN
Talajíc
M
M
D003327:Coronary Disease / Q000150:complications* / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004558:Electric Stimulation; D004562:Electrocardiography; D006801:Humans; D012044:Regression Analysis; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology; D017180:Tachycardia, Ventricular / Q000209:etiology*