title: Predictors of ventricular tachycardia induction in syncopal patients with mild to moderate left ventricular dysfunction.
abstract: BACKGROUND
  In patients with mild to moderate left ventricular dysfunction (LVD) (35% pound LVEF pound 50%) who present with syncope, demonstration of tachy and/or brady-arrhythmia has prognostic value. In this group of patients electrophysiological study (EPS) is often necessary.
  
  
  METHODS
  A total of 53 consecutive patients with mild to moderate LVD and history of undetermined syncope underwent EPS. Sinus node function, His-Purkinje system conduction and ventricular electrical stability were evaluated.
  
  
  RESULTS
  Twenty eight patients (52.8%) had induction of sustained monomorphic ventricular tachycardia (VT) and five (9.4%) patients had a sustained ventricular arrhythmia other than monomorphic VT (ventricular flutter, ventricular fibrillation, and polymorphic VT) induced during EPS. Abnormal sinus node function and/or His-Purkinje system conduction was found in five (9.4%) patients. Age, gender, history of myocardial infarction, type of underlying heart disease and history of revascularization were not predictors of VT induction. Wide QRS morphology independently, and lower left ventricular ejection fraction and presence of pathologic q wave in precordial leads dependently, could increase risk of VT induction.
  
  
  CONCLUSIONS
  The EPS can determine which patient with syncope and mild to moderate LVD is likely to benefit from placing an ICD for prevention of sudden cardiac death. Pathologic precordial q wave, wide QRS morphology and lower left ventricular ejection fraction could be predictors of VT induction during EPS. Wide QRS morphology has an independent effect in this category.
authors: Department of Pacemaker and Electrophysiology, Rajaie Cardiovascular Medical and Research Center, Iran. fazelifar@gmail.com
authors: Amir Farjam
authors: AF
authors: Fazelifar
authors: Peyman
authors: P
authors: Ashrafi
authors: Majid
authors: M
authors: Haghjoo
authors: Zahra Ojaghi
authors: ZO
authors: Haghighi
authors: Hooman Bakhshandeh
authors: HB
authors: Abkenar
authors: Ashrafossadat
authors: A
authors: Ashour
authors: Shahrbanou
authors: S
authors: Azari
authors: Azam
authors: A
authors: Forghanian
authors: Mohammad Ali
authors: MA
authors: Sadr-Ameli
mesh_terms: D000328:Adult; D000368:Aged; D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D012849:Sinoatrial Node / Q000503:physiopathology; D013575:Syncope / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology