title: "Stable" ventricular tachycardia is not a benign rhythm : insights from the antiarrhythmics versus implantable defibrillators (AVID) registry.
abstract: BACKGROUND
  Sustained ventricular tachycardia (VT) can be unstable, can be associated with serious symptoms, or can be stable and relatively free of symptoms. Patients with unstable VT are at high risk for sudden death and are best treated with an implantable defibrillator. The prognosis of patients with stable VT is controversial, and it is unknown whether implantable cardioverter-defibrillator therapy is beneficial.
  
  
  RESULTS
  Screening for the Antiarrhythmics Versus Implantable Defibrillators (AVID) trial identified patients with both stable and unstable VT. Both groups were included in a registry, and their clinical characteristics and discharge treatments were recorded. Mortality data were obtained through the National Death Index. The mortality in 440 patients with stable VT tended to be greater than that observed in 1029 patients presenting with unstable VT (33.6% versus 27.6% at 3 years; relative risk [RR]=1.22; P:=0.07). After adjustment for baseline and treatment differences, the RR was little changed (RR=1.25, P:=0.06).
  
  
  CONCLUSIONS
  Sustained VT without serious symptoms or hemodynamic compromise is associated with a high mortality rate and may be a marker for a substrate capable of producing a more malignant arrhythmia. Implantable cardioverter-defibrillator therapy may be indicated in patients presenting with stable VT.
authors.affiliation: Portland VA Medical Center, Portland, Ore., USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Raitt
authors.forename: E G
authors.initials: EG
authors.lastname: Renfroe
authors.forename: A E
authors.initials: AE
authors.lastname: Epstein
authors.forename: J H
authors.initials: JH
authors.lastname: McAnulty
authors.forename: P
authors.initials: P
authors.lastname: Mounsey
authors.forename: J S
authors.initials: JS
authors.lastname: Steinberg
authors.forename: S E
authors.initials: SE
authors.lastname: Lancaster
authors.forename: R L
authors.initials: RL
authors.lastname: Jadonath
authors.forename: A P
authors.initials: AP
authors.lastname: Hallstrom
mesh_terms: D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D018849:Controlled Clinical Trials as Topic; D017147:Defibrillators, Implantable; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D012042:Registries; D012306:Risk; D013015:Sotalol / Q000627:therapeutic use*; D017180:Tachycardia, Ventricular / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*
chemical_list: D000889:Anti-Arrhythmia Agents; D013015:Sotalol; D000638:Amiodarone