Document Detail


Comparison of event rates and survival in patients with unexplained syncope without documented ventricular tachyarrhythmias versus patients with documented sustained ventricular tachyarrhythmias both treated with implantable cardioverter-defibrillators.
MedLine Citation:
PMID:  12000047     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with unexplained syncope and inducible ventricular tachyarrhythmias during electrophysiologic testing have an increased cardiac mortality rate. We compared event rates and survival of 178 patients with unexplained syncope and no documented ventricular arrhythmias (syncope group) versus 568 patients with documented sustained ventricular tachycardia (VT or fibrillation (VF) (VT/VF group) treated, as part of a lead (Ventritex TVL) investigation, with similar implantable cardioverter-defibrillators (ICDs) capable of extensive data storage. The 2 groups shared similar clinical characteristics. The mean follow-up was 11 months for the syncope group and 14 months for the VT/VF group. The mean time from device implantation to first appropriate therapy was similar in the 2 groups (109 +/- 140 vs 93 +/- 131 days, p = 0.40). Actuarial probability of appropriate ICD therapy was 49% and 55% at 1 and 2 years, respectively, in syncope group and 49% and 58% in VT/VF group (p = 0.57). Recurrent syncope was associated with ventricular tachyarrhythmias in 85% and 92% of the syncope group and VT/VF group, respectively (p = 0.54). At 2 years, actuarial survival was 91% in the syncope group and 93% in VT/VF group (p = 0.85). We conclude that patients treated with ICD with unexplained syncope and induced VT/VF have an equally high incidence of appropriate ICD therapy and low mortality compared with similar patients with documented VT/VF. These findings, plus the high association between recurrent syncope and ventricular arrhythmias, indicate that VT/VF are likely etiologies in selected patients with unexplained syncope and support ICD therapy in such cases.
Authors:
L A Pires; L M May; S Ravi; J T Parry; V R Lal; C L Nino
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  85     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2002-05-09     Completed Date:  2002-05-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  725-8     Citation Subset:  AIM; IM    
Affiliation:
St John Hospital and Medical Center and Wayne State University School of Medicine Detroit, Michigan 48236, USA. kuis.pires@stjohn.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Case-Control Studies
Defibrillators, Implantable*
Female
Humans
Male
Middle Aged
Survival Rate
Syncope / mortality*
Tachycardia, Ventricular / mortality*,  therapy*
Ventricular Fibrillation / mortality*,  therapy*

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


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