Document Detail

Value of different non-invasive methods for the recognition of arrhythmogenic complications in high-risk patients with sustained ventricular tachycardia during programmed ventricular stimulation.
MedLine Citation:
PMID:  8223754     Owner:  NLM     Status:  MEDLINE    
It is well known that patients with coronary heart disease and ventricular tachycardia show a high incidence of arrhythmogenic complications and sudden cardiac death. The best predictor of spontaneous ventricular tachycardia and sudden death in these patients is programmed ventricular stimulation, but this invasive method is limited to specialized institutions. The purpose of our study was to assess the predictive value of Holter monitoring, late potentials and heart rate variability as markers for these high-risk patients. We investigated 20 patients (18 m, 2 f, age range 31-79 years) with coronary artery disease documented angiographically (6 patients with single vessel disease (vd), nine patients with 2 vd, five patients with 3 vd) and previous myocardial infarction. Each patient underwent 24-h ambulatory monitoring with analysis of rhythm of heart rate variability (24-h spectral and non-spectral analysis) and a signal-averaged ECG with late potential measurement. In all patients, sustained ventricular tachycardia was inducible during programmed ventricular stimulation. Late potentials were recorded in 12 out of the 20 patients (60%). Ventricular arrhythmias of Lown classes IVa, IVb or V were recorded in 12 patients. Analysis of heart rate variability compared to 20 age- and sex-matched healthy controls revealed a loss of parasympathic activity and increased sympathic activity in 16 of the 20 patients (80%). Conclusion: in this study, heart rate variability was the most sensitive method with which to recognize patients at a high risk of arrhythmogenic complications. Evaluation of the above parameters in large controlled clinical trials may help predict arrhythmogenic complications and sudden cardiac death.
H H Osterhues; T Eggeling; M Höher; P Weismüller; M Kochs; V Hombach
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  14 Suppl E     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1993 Sep 
Date Detail:
Created Date:  1993-12-16     Completed Date:  1993-12-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  40-5     Citation Subset:  IM    
Department of Cardiology, University of Ulm, Germany.
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MeSH Terms
Action Potentials
Arrhythmias, Cardiac / diagnosis*,  etiology,  physiopathology
Coronary Disease / complications,  physiopathology*
Electric Stimulation
Electrocardiography, Ambulatory*
Heart Rate* / physiology
Middle Aged
Predictive Value of Tests
Sensitivity and Specificity
Stroke Volume
Tachycardia, Ventricular / physiopathology

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