title: Long-term outcome of patients who received implantable cardioverter defibrillators for stable ventricular tachycardia.
abstract: BACKGROUND
  Evidence is inconclusive concerning the role of implantable cardioverter defibrillators (ICDs) to treat patients with hemodynamically stable ventricular tachycardia (VT). The goal of this study was to estimate future risk of unstable ventricular arrhythmias in patients who received ICDs for stable VT.
  
  
  RESULTS
  We reviewed complete ICD follow-up data from 82 patients (age 66.1 +/- 11.3 years; left ventricular ejection fraction 32.3%+/- 11.2%; mean +/- SD) who received ICDs for stable VT. During the follow-up period of 23.6 +/- 21.5 months (mean +/- SD), 15 patients (18%) died, and 10 (12%) developed unstable ventricular arrhythmia, 8 of whom had the unstable arrhythmia as the first arrhythmia after ICD placement. Estimated 2- and 4-year survival in the whole group was 80% and 74%, respectively. Estimated 2- and 4-year probability of any VT and unstable VT was 67% and 77% and 11% and 25%, respectively. There were no differences in age, ejection fraction, sex, underlying heart disease, cycle length, symptoms, baseline electrophysiologic study results, or QRS characteristics of qualifying VT between patients who developed unstable ventricular arrhythmia and patients who did not. Twenty-nine patients (35%) had at least one inappropriate shock, and 11 (13%) underwent further surgery for ICD-related complications.
  
  
  CONCLUSIONS
  Patients who present with hemodynamically stable VT are at risk for subsequent unstable VT. ICD treatment offers potential salvage of patients with stable VT who subsequently develop unstable VT/ventricular fibrillation, although complications and inappropriate shocks are considerable. No predictors could be found for high and low risk for unstable arrhythmias. These findings support ICD treatment for stable VT survivors.
authors.affiliation: Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Glikson
authors.forename: Igor
authors.initials: I
authors.lastname: Lipchenca
authors.forename: Sami
authors.initials: S
authors.lastname: Viskin
authors.forename: Karla V
authors.initials: KV
authors.lastname: Ballman
authors.forename: Jane M
authors.initials: JM
authors.lastname: Trusty
authors.forename: Osnat T
authors.initials: OT
authors.lastname: Gurevitz
authors.forename: David M
authors.initials: DM
authors.lastname: Luria
authors.forename: Michael
authors.initials: M
authors.lastname: Eldar
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Hammill
authors.forename: Paul A
authors.initials: PA
authors.lastname: Friedman
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002304:Cardiac Pacing, Artificial; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology; D017180:Tachycardia, Ventricular / Q000145:classification / Q000503:physiopathology / Q000628:therapy*; D013995:Time; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents