Document Detail


Clinical and electrophysiologic predictors of ventricular tachyarrhythmia recurrence in patients with implantable cardioverter defibrillators.
MedLine Citation:
PMID:  12776866     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Not all patients experience recurrent sustained ventricular tachyarrhythmias after placement of an implantable cardioverter defibrillator (ICD). We evaluated the clinical and electrophysiologic predictors of ventricular tachycardia (VT) and ventricular fibrillation (VF) recurrence following ICD implantation. METHODS AND RESULTS: Consecutive patients (n = 133) underwent 4 +/- 3 serial electrophysiologic studies (EPS) over 50 +/- 26 months following ICD implantation. Sustained VT/VF could always be induced during follow-up EPS in 49 patients; sustained VT/VF was sometimes induced during follow-up EPS in 47 patients; and sustained VT/VF could never be induced during follow-up EPS in 37 patients. Spontaneous VT/VF requiring ICD therapy occurred in 107 patients during follow-up. Patients with sustained VT/VF that was always inducible or sometimes inducible during follow-up experienced more frequent episodes of VT/VF following ICD implant (20.5, 95% CI 12.7-33.0; and 17.8, 95% CI 11.3-28.1 episodes/patient respectively; vs 3.0, 95% CI 2.0-4.6 episodes/patient for patients with VT/VF never induced, P < 0.001). Inducibility of sustained VT/VF post-ICD implant (P < 0.001) and sustained VT as the presenting arrhythmia (P = 0.02) were independent predictors of spontaneous VT/VF recurrence. CONCLUSION: Reproducibly inducible VT/VF following ICD implantation predicts a high probability of VT/VF recurrence and identifies a cohort of patients who experience frequent episodes of VT/VF over time. Persistent noninducibility of sustained VT/VF identifies a group of patients who experience no or very few episodes of VT/VF recurrence.
Authors:
Anne M Gillis; Robert S Sheldon; D George Wyse; Henry J Duff; Margaret R Cassidy; L Brent Mitchell
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  14     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-06-02     Completed Date:  2003-10-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  492-8     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Foothills Hospital and Cardiovascular Research Group, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. amgillis@ucalgary.ca
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MeSH Terms
Descriptor/Qualifier:
Aged
Cohort Studies
Defibrillators, Implantable*
Electrophysiologic Techniques, Cardiac*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Recurrence
Sensitivity and Specificity
Stroke Volume / physiology
Tachycardia, Ventricular / etiology*,  physiopathology,  therapy*
Time Factors
Treatment Outcome
Ventricular Fibrillation / etiology,  physiopathology,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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