Document Detail


Study of precursors of ventricular tachycardia from data stored in the memory of a dual chamber implantable cardioverter defibrillator.
MedLine Citation:
PMID:  12914621     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study was performed to examine precursors of ventricular tachyarrhythmias in patients who experienced a sustained ventricular tachyarrhythmia and received appropriate therapy by ICD. From an overall consecutive population of 77 patients, 18 patients (1 woman, mean age 61.7 +/- 10.8 years) were selected for having experienced a sustained ventricular tachyarrhythmia and received at least one appropriate ICD therapy preceded by 20 minutes of internal information. The number of premature ventricular complexes (PVCs)/min for each of the 20 minutes preceding the onset of ventricular tachyarrhythmia, the shortest coupling intervals between PVC and normal sinus beat, and the presence of short-long-short (SLS) interval sequences were examined. Data were stratified according to underlying disease, left ventricular ejection fraction, rate of ventricular tachyarrhythmia, and antiarrhythmic therapy. One hundred twenty-eight episodes of spontaneous ventricular tachyarrhythmia were retrieved. Rapid ventricular tachyarrhythmia (>160 beats/min) were preceded by a significantly greater mean number (3.71 +/- 6.36)of PVCs than slower ventricular tachyarrhythmia (<or=160 beats/min) (0.63 +/- 0.88, P = 0.0004). The mean shortest PVC coupling interval was significantly shorter in patients with (588 +/- 99 ms) versus without (643 +/- 111 ms, P = 0.03)ischemic heart disease, before episodes of rapid(527 +/- 55 ms)versus slower (636 +/- 105 ms, P = 0.0001)ventricular tachyarrhythmia, and in the absence (538 +/- 80 ms)versus the presence(620 +/- 105 ms, P = 0.006)of amiodarone. SLS sequences preceded 29% of rapid ventricular tachyarrhythmic episodes, versus 8% of the slower ventricular tachyarrhythmia (P < 0.01). Significant differences were found in the characteristics of PVCs preceding ventricular tachyarrhythmic episodes in accordance to their rate and the underlying cardiomyopathy. Though insufficient in isolation, these findings may be helpful when combined with other observations to develop preventive algorithms, or to refine the programming of implantable devices.
Authors:
Antoine Leenhardt; Nicolas Sadoul; Philippe Mabo; Salem Kacet; Thomas Lavergne; Nadir Saoudi; Nicolas Iscolo;
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  26     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-08-13     Completed Date:  2003-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1454-60     Citation Subset:  IM    
Affiliation:
Lariboisière Hospital, Paris, France. antoine.leenhardt@lrb.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Amiodarone / therapeutic use
Anti-Arrhythmia Agents / therapeutic use
Defibrillators, Implantable*
Female
Humans
Male
Middle Aged
Stroke Volume
Tachycardia, Ventricular / complications,  physiopathology*,  therapy
Ventricular Function, Left
Ventricular Premature Complexes / complications,  diagnosis
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 1951-25-3/Amiodarone

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


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