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Right Ventricular Dysfunction Predisposes to Inducible Ventricular Tachycardia at Electrophysiology Studies in Patients with Acute ST Elevation Myocardial Infarction and Reduced Left Ventricle Ejection Fraction.
MedLine Citation:
PMID:  25108742     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -Inducible Ventricular tachycardia (VT) is a strong predictor of spontaneous ventricular tachyarrhythmia following ST elevation myocardial infarction (STEMI). Reduced left ventricular ejection fraction (LVEF) predisposes patients to inducible ventricular tachycardia post STEMI. However the role of right ventricular (RV) dysfunction in predisposing to inducible VT has not been described previously.
METHODS AND RESULTS: -Consecutive patients with STEMI treated with primary percutaneous coronary intervention (PPCI) underwent pre-discharge radionuclide gated heart pool scan (GHPS) to assess ventricular ejection fraction (EF). The study cohort included patients with reduced LVEF (LVEF ≤40%), that underwent electrophysiology study (EPS) (n=220) in an attempt to induce VT. We defined RV dysfunction as right ventricular ejection fraction (RVEF) ≤35%. The end point was sustained monomorphic VT (Cycle length CL ≥200ms). This was considered a positive study. No inducible arrhythmia, ventricular fibrillation or flutter (CL<200ms) was considered a negative study. Infarct region, infarct related artery, male gender and RVEF ≤35%, were univariable predictors of positive test. After multivariable analysis, RVEF ≤35% had the strongest association as an independent predictor of inducible VT at EPS (p<0.001, OR 5.8; 95% CI, 3.005 to 11.262).
CONCLUSIONS: -RV dysfunction (RVEF ≤35%) predisposed to inducible VT at EPS in patients with impaired LVEF (≤ 40%) after acute STEMI treated with primary PCI.
Authors:
Jay B Thakkar; Sarah Zaman; Karen Byth; Arun Narayan; Aravinda Thiagalingam; Clara Chow; Stuart P Thomas; Gopal Sivagangabalan; David Farlow; Robert Barnett; Pramesh Kovoor
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-9
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  -     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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