title: Long-term outcomes of inducible very fast ventricular tachycardia (cycle length 200-250 ms) in patients with ischemic cardiomyopathy.
abstract: BACKGROUND
  The long-term outcomes of patients with inducible very fast ventricular tachycardia (VFVT) of cycle length (CL) 200 to 250 ms have not been well studied.
  
  
  METHODS
  Consecutive patients with ischemic cardiomyopathy with a left ventricular ejection fraction (LVEF) of <or=40% (n = 300) underwent programmed ventricular stimulation (PVS) and were divided into 4 groups based on results of the study. Group A were noninducible, had induced ventricular fibrillation (VF), or polymorphic VT (CL < 200 ms); group B had inducible VFVT (200-250 ms); group C had inducible fast ventricular tachycardia (FVT; CL 251-320 ms); and group D had inducible slow VT (CL >320 ms). The primary endpoint was spontaneous ventricular arrhythmia or sudden death.
  
  
  RESULTS
  The mean age was 63 +/- 12 years and mean LVEF was 29 +/- 7%. At mean follow-up of 38 +/- 25 months (median 30 months), the primary endpoint rate was 6.6%, 34%, 44%, and 71% in groups A, B C, and D, respectively (P < 0.001). Neither mode of induction of VT nor LVEF altered the observed pattern in the primary endpoint. There was no significant difference in the primary endpoint among implanted cardioverter defibrillator recipients in groups B and C (38% vs 45%, P = 0.43). Adjusted hazard ratios for the primary endpoint compared to group A were 3.2, 3.5, and 7.0 in groups B, C, and D, respectively (P < 0.05).
  
  
  CONCLUSIONS
  Inducible VFVT (200-250 ms) is a clinically significant arrhythmia with adverse long-term outcomes and should not be considered a nonspecific finding of PVS.
authors.affiliation: Department of Cardiology, Westmead Hospital, Sydney, Australia.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Kumar
authors.forename: Gopal
authors.initials: G
authors.lastname: Sivagangabalan
authors.forename: Man-Chun
authors.initials: MC
authors.lastname: Choi
authors.forename: Vicki
authors.initials: V
authors.lastname: Eipper
authors.forename: Aravinda
authors.initials: A
authors.lastname: Thiagalingam
authors.forename: Pramesh
authors.initials: P
authors.lastname: Kovoor
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis*; D011379:Prognosis; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000209:etiology*