Document Detail


Differences in mechanisms and outcomes of syncope in patients with coronary disease or idiopathic left ventricular dysfunction as assessed by electrophysiologic testing.
MedLine Citation:
PMID:  15358027     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study evaluated the causes of syncope and the significance and differences in left ventricular (LV) dysfunction, coronary disease, and idiopathic dilated cardiomyopathy (DCM). BACKGROUND: Risk stratification of and indications for an automated defibrillator could differ according to the cause of LV dysfunction. METHODS: Electrophysiologic study, including atrial and ventricular programmed stimulation, was performed in 119 patients with coronary disease (group I) and 61 patients with DCM (group II) with an left ventricular ejection fraction (LVEF) <40% and syncope. Patients were followed from one to six years (mean 4 +/- 2 years). RESULTS: Sustained monomorphic ventricular tachycardia (VT) was induced in 44 group I patients (37%) and 13 group II patients (21%); ventricular flutter (>270 beats/min) or ventricular fibrillation (VF) was induced in 24 group I patients (19%) and 9 group II patients (15%); and various other arrhythmias were identified. Syncope remained unexplained in 34 group I patients (30%) and 16 group II patients (27%). Prognosis depended on the heart disease: VT or VF induction was a predictive factor of mortality in coronary disease and identified a group with high cardiac mortality (46%), compared with patients with a negative study, who had a lower mortality (6%; p < 0.001) than in other studies. Cardiac mortality was only correlated with LVEF in DCM. CONCLUSIONS: Various causes could explain syncope in 70% of patients with coronary disease and DCM, but differences were noted: VT was frequent in coronary disease with a bad prognosis, and ischemia could explain syncope; in DCM, different causes such as atrial tachycardia could be responsible for syncope, but the prognosis only depended on LVEF.
Authors:
Béatrice Brembilla-Perrot; Christine Suty-Selton; Daniel Beurrier; Pierre Houriez; Marc Nippert; Arnaud Terrier de la Chaise; Pierre Louis; Olivier Claudon; Marius Andronache; Ahmed Abdelaal; Ahmed Abdelaah; Nicolas Sadoul; Yves Juillière
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  44     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-09-13     Completed Date:  2004-09-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  594-601     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, CHU of Brabois, Vandoeuvre Les Nancy, France. b.brembilla-perrot@chu-nancy.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cardiomyopathy, Dilated / complications*,  mortality,  physiopathology
Coronary Artery Disease / complications*,  mortality,  physiopathology
Defibrillators, Implantable
Female
Follow-Up Studies
Humans
Male
Middle Aged
Predictive Value of Tests
Prognosis
Risk Assessment
Stroke Volume*
Survival Analysis
Syncope / etiology,  physiopathology*,  prevention & control*
Treatment Outcome
Ventricular Dysfunction, Left / complications*,  physiopathology
Ventricular Fibrillation / complications,  etiology,  physiopathology,  therapy*
Comments/Corrections
Erratum In:
J Am Coll Cardiol. 2004 Nov 2;44(9):1936
Note: Abdelaah, Ahmed [corrected to Abdelaal, Ahmed]

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


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