Limited predictive value of inducible sustained ventricular tachycardia for future occurrence of spontaneous ventricular tachycardia in patients with coronary artery disease and relatively preserved cardiac function.
To evaluate the significance of inducible sustained ventricular tachycardia (VT) in patients with coronary artery disease and relatively preserved cardiac function, 33 patients who met the following criteria were studied; documented nonsustained VT but no history of life-threatening arrhythmia, inducible sustained VT at electrophysiologic study, and implantation of a cardioverter-defibrillator. Eighteen patients developed clinical sustained VT within 2 years. By univariate analysis, left ventricular ejection fraction (EF) and the cycle length of induced VT were associated with clinical VT occurrence. By multivariate analysis, however, EF was the only independent predictor. Among 23 patients with EF <or=40%, 16 patients developed clinical sustained VT compared to 2 of 10 patients with EF >40% (P <.01). In coronary artery disease patients with relatively preserved EF, the incidence of clinical VT is considerably low even though sustained VT is inducible. Inducible VT is therefore not appropriate for risk stratification in this patient population.
Matsushita
Takehiko
T
Cardiac Electrophysiology & Arrhythmia Service, Stanford University Medical Center, Stanford, CA, USA. t-matsu@m2.kufm.kagoshima-u.ac.jp
Chun
Sung
S
Liem
L Bing
LB
Friday
Karen J
KJ
Sung
Ruey J
RJ
D000368:Aged; D002304:Cardiac Pacing, Artificial; D003324:Coronary Artery Disease / Q000150:complications; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010138:Pacemaker, Artificial; D011336:Probability; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology*; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy