A prospective study on the risk-stratification for patients with non-sustained ventricular tachycardia using a novel algorithm.
BACKGROUND
The therapeutic strategy for non-sustained ventricular tachycardia (NSVT), considered as a risk-stratifier for sudden cardiac death (SCD), still remains undetermined.


RESULTS
In the present study 222 of 4,079 patients (5.4%) hospitalized with NSVT during 2002 to 2004 were prospectively evaluated using an algorithm for risk-stratification according to each type of structural heart disease. The algorithm comprises the left ventricular ejection fraction, signal-averaged electrocardiography, programmed ventricular stimulation and the family history of SCD. Of the 222 patients, 151 (68.0%) were successfully risk-stratified and 32 patients consequently received an implantable cardioverter defibrillator (ICD) (21.2%; algorithm-ICD group). The remaining 119 patients without an ICD (algorithm-observation group) were observed. During 27.7+/-11.4 months of follow-up, the patients in the algorithm-ICD group had a significantly higher prevalence of tachyarrhythmic events than did those in the algorithm-observation group (9/32 vs 1/119; p<0.05). In the algorithm-ICD group, 2, 1 and 6 patients experienced an SCD, aborted SCD and appropriate ICD intervention, respectively, while there was only 1 SCD in the algorithm-observation group.


CONCLUSIONS
The proposed algorithm for risk-stratification of patients with NSVT may be feasible for appropriate selection of high-risk patients and candidates for prophylactic ICD implantation.
Ueno
Akira
A
Department of Internal Medicine, Division of Cardiology, Nippon Medical School, Tokyo, Japan. s4013@nms.ac.jp
Kobayashi
Yoshinori
Y
Yodogawa
Kenji
K
Miyauchi
Yasushi
Y
Yajima
Toshimi
T
Nitta
Takashi
T
Kato
Takao
T
Takano
Teruo
T
D000368:Aged; D000465:Algorithms; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000517:prevention & control; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000453:epidemiology* / Q000628:therapy