Document Detail


Long-term outcome of patients who received implantable cardioverter defibrillators for stable ventricular tachycardia.
MedLine Citation:
PMID:  15175060     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Evidence is inconclusive concerning the role of implantable cardioverter defibrillators (ICDs) to treat patients with hemodynamically stable ventricular tachycardia (VT). The goal of this study was to estimate future risk of unstable ventricular arrhythmias in patients who received ICDs for stable VT. METHODS AND RESULTS: We reviewed complete ICD follow-up data from 82 patients (age 66.1 +/- 11.3 years; left ventricular ejection fraction 32.3%+/- 11.2%; mean +/- SD) who received ICDs for stable VT. During the follow-up period of 23.6 +/- 21.5 months (mean +/- SD), 15 patients (18%) died, and 10 (12%) developed unstable ventricular arrhythmia, 8 of whom had the unstable arrhythmia as the first arrhythmia after ICD placement. Estimated 2- and 4-year survival in the whole group was 80% and 74%, respectively. Estimated 2- and 4-year probability of any VT and unstable VT was 67% and 77% and 11% and 25%, respectively. There were no differences in age, ejection fraction, sex, underlying heart disease, cycle length, symptoms, baseline electrophysiologic study results, or QRS characteristics of qualifying VT between patients who developed unstable ventricular arrhythmia and patients who did not. Twenty-nine patients (35%) had at least one inappropriate shock, and 11 (13%) underwent further surgery for ICD-related complications. CONCLUSION: Patients who present with hemodynamically stable VT are at risk for subsequent unstable VT. ICD treatment offers potential salvage of patients with stable VT who subsequently develop unstable VT/ventricular fibrillation, although complications and inappropriate shocks are considerable. No predictors could be found for high and low risk for unstable arrhythmias. These findings support ICD treatment for stable VT survivors.
Authors:
Michael Glikson; Igor Lipchenca; Sami Viskin; Karla V Ballman; Jane M Trusty; Osnat T Gurevitz; David M Luria; Michael Eldar; Stephen C Hammill; Paul A Friedman
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  15     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-03     Completed Date:  2004-11-06     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:  658-64     Citation Subset:  IM    
Affiliation:
Sheba Medical Center, Tel Hashomer, Israel.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Arrhythmia Agents / therapeutic use
Cardiac Pacing, Artificial
Defibrillators, Implantable*
Electrocardiography
Electrophysiologic Techniques, Cardiac
Female
Follow-Up Studies
Heart Conduction System / pathology,  physiopathology
Humans
Israel
Male
Middle Aged
Minnesota
Postoperative Complications / drug therapy,  etiology,  physiopathology
Prospective Studies
Stroke Volume / physiology
Tachycardia, Ventricular / classification,  physiopathology,  therapy*
Time
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents
Comments/Corrections
Comment In:
J Cardiovasc Electrophysiol. 2004 Jun;15(6):665-6   [PMID:  15175061 ]

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