Angiographic left ventricular wall motion score to predict arrhythmia recurrence in patients with sustained ventricular tachycardia or fibrillation.
METHODS
Sixty-nine patients with sustained ventricular tachyarrhythmias were followed up to evaluate the predictive value of functional capacity (i.e., New York Heart Association class and peak oxygen consumption) and resting left ventricular function (i.e. radionuclide left ventricular ejection fraction, angiographic left ventricular wall motion score and echocardiographic dimensions) with respect to arrhythmia recurrence.


RESULTS
During a mean follow-up of 19 months 18 patients (26%) had an arrhythmia recurrence. Parameters of functional capacity and echocardiographic dimensions were not related to arrhythmia recurrence. Left ventricular ejection fraction and wall motion score were worse in patients with a recurrence compared with the arrhythmia-free patients: 30 +/- 16% versus 40 +/- 19% (mean +/- SD, P = 0.035) and 25 +/- 7 versus 20 +/- 7 (P = 0.01), respectively. Multivariately the most powerful parameter was left ventricular wall motion score (odds ratio 1.12, 95% Cl 1.02-1.23).


CONCLUSIONS
Arrhythmia recurrence in ventricular tachyarrhythmia patients relates to resting left ventricular function and not to functional capacity. Since angiographic left ventricular wall motion score is prognostically more important than ejection fraction this parameter should be considered for risk stratification in these patients.
Wiesfeld
A C
AC
Department of Cardiology, University Hospital Groningen, The Netherlands.
Crijns
H J
HJ
Van den Broek
S A
SA
Landsman
M L
ML
Hillege
H L
HL
van Gilst
W H
WH
Lie
K I
KI
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D017023:Coronary Angiography / Q000379:methods*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D017180:Tachycardia, Ventricular / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D014693:Ventricular Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy
D000889:Anti-Arrhythmia Agents