title: Long-term prognosis of inducible ventricular flutter: not an innocent finding.
abstract: BACKGROUND
  The prognostic significance of ventricular flutter (VFL) induced during programmed electrical stimulation (PES) is currently unknown.
  
  
  METHODS
  This study examined patients who had PES-induced VFL and assessed their long-term prognosis compared with patients who had inducible sustained monomorphic ventricular tachycardia (SMVT).
  
  
  RESULTS
  Of 3414 patients undergoing PES, 74 (2%) had sustained VFL. They were compared with a group of 71 patients undergoing PES in the same time frame who had inducible SMVT. Patients with inducible VFL had a higher ejection fraction than patients with SMVT (0.39 vs 0.33; P =.05). More aggressive pacing was required for arrhythmia induction in patients with VFL, with more stimuli (2.7 +/- 0.5 vs 2.2 +/- 0.6; P <.01) and tighter S(2), S(3), and S(4) intervals. After a mean follow-up of 30 +/- 31 months, the mortality rate was 34% in patients with VFL and 30% in patients with SMVT (P =.41). No difference in the 2 groups in overall survival or a combined end point of sudden death or appropriate implantable cardioverter defibrillator shock was revealed with Kaplan-Meier analysis.
  
  
  CONCLUSIONS
  The long-term prognosis of patients with inducible VFL is similar to that of patients with inducible SMVT, even when VFL is induced with a relatively aggressive protocol.
authors.affiliation: Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Osnat
authors.initials: O
authors.lastname: Gurevitz
authors.forename: Sami
authors.initials: S
authors.lastname: Viskin
authors.forename: Michael
authors.initials: M
authors.lastname: Glikson
authors.forename: Karla V
authors.initials: KV
authors.lastname: Ballman
authors.forename: A Gabriela
authors.initials: AG
authors.lastname: Rosales
authors.forename: Win-Kuang
authors.initials: WK
authors.lastname: Shen
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Hammill
authors.forename: Paul A
authors.initials: PA
authors.lastname: Friedman
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D002423:Cause of Death; D022062:Electrophysiologic Techniques, Cardiac; D005500:Follow-Up Studies; D006352:Heart Ventricles; D006801:Humans; D011379:Prognosis; D012306:Risk; D013318:Stroke Volume; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology / Q000401:mortality