Document Detail

Significance of inducible ventricular flutter/fibrillation in risk stratification in patients with coronary artery disease.
MedLine Citation:
PMID:  14996477     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although inducible ventricular fibrillation (VF) has been used as an indication for prophylactic implantation of cardioverter-defibrillators (ICDs) in patients with coronary artery disease (CAD), the significance of inducible VF remains controversial. METHODS: Among 364 CAD patients who underwent electrophysiologic (EP) study for risk stratification, 23 patients, 12 without any history of VF or cardiac arrest (group A) and 11 with previously documented VF or cardiac arrest (group B), exhibited inducible ventricular flutter (VFL) or VF and subsequently underwent ICD implantation. Additionally, 11 CAD patients without previous VF or cardiac arrest, who had no inducible ventricular tachyarrhythmias but received an ICD, were included for comparison (group C). RESULTS: During 2 years of follow-up, 1 (8%), 5 (45%), and 1 (9%) patients had appropriate ICD shocks in groups A, B, and C, respectively. The survival free from appropriate ICD shocks was significantly lower in group B compared to groups A and C (p<0.05). There were no significant differences in age, sex, ejection fraction (EF), or induction protocol between groups A and B or between groups A and C. CONCLUSIONS: In CAD patients with inducible VFL/VF, patients without any history of VF or cardiac arrest had significantly lower incidence of appropriate ICD shocks when compared to those with such clinical events. Conversely, in CAD patients without any history of VF or cardiac arrest, incidence of appropriate ICD shocks was similar regardless of inducible VFL/VF. Inducible VFL/VF is therefore not useful as an indication for prophylactic ICD implantation in this patient population.
Takehiko Matsushita; Sung Chun; L Bing Liem; Karen J Friday; Ruey J Sung
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  94     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-03     Completed Date:  2004-08-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  67-71     Citation Subset:  IM    
Cardiac Electrophysiology and Arrhythmia Service, Stanford University Medical Center, 300 Pasteur Drive Room H2146, Stanford, CA 94305-5233, USA.
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MeSH Terms
Coronary Artery Disease / complications*,  prevention & control,  therapy
Defibrillators, Implantable
Electrophysiologic Techniques, Cardiac
Follow-Up Studies
Middle Aged
Risk Factors
Ventricular Fibrillation / etiology*,  therapy

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