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Comparative Study
. 2003 Jun;89(6):629-32.
doi: 10.1136/heart.89.6.629.

Comparative follow up of patients with implanted cardioverter-defibrillators after induction of sustained monomorphic ventricular tachycardias or ventricular fibrillation by programmed stimulation

M Meyborg  1 , R Mura, C Tiefenbacher, R Becker, J Michaelsen, F Niroomand
Affiliations
Comparative Study

Comparative follow up of patients with implanted cardioverter-defibrillators after induction of sustained monomorphic ventricular tachycardias or ventricular fibrillation by programmed stimulation

M Meyborg et al. Heart. 2003 Jun.

Abstract

Objective: To investigate the prognostic value of induced monomorphic ventricular tachycardia (VT) and ventricular flutter or fibrillation (VF) during programmed electrical stimulation in patients with a high risk for sudden arrhythmogenic cardiac death.

Design: Prospective cohort study.

Patients: 102 patients at high risk for arrhythmogenic sudden cardiac death who received an automated implantable cardioverter-defibrillator (AICD) were evaluated. 56 patients received the AICD for primary prevention and 46 for secondary prevention. 58 patients had induction of a monomorphic VT (VT group) and 44 had induction of a polymorphic VT, ventricular flutter, or ventricular fibrillation (VF group) during programmed electrical stimulation. Average follow up was 20 months in both groups.

Main outcome measures: Appropriate AICD protocol.

Results: In patients who received the AICD for primary prevention, 16 of 32 patients in the VT group, compared with only four of 24 patients in the VF group, received an appropriate AICD protocol (p = 0.02). In the entire study population, 479 appropriate AICD protocols were recorded in 28 (48%) patients in the VT group and 28 appropriate protocols in 11 (25%) patients in the VF group. Cumulative Kaplan-Meier event-free survival curves were significantly different (p = 0.02).

Conclusion: Induction of VF during programmed electrical stimulation is of no prognostic value even in high risk patients without previously documented ventricular fibrillation.

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Figures

Figure 1
Figure 1
Patient selection protocol. Patients were recruited from 694 consecutive patients who underwent programmed electrical stimulation. An automated implantable cardioverter defibrillator was implanted in 122 of 186 patients with induction of a sustained ventricular tachyarrhythmia and impaired left ventricular function, and they were eligible for the study. Follow up data were obtained from all 102 patients who had their follow up at the study centre. AICD, automated implantable cardioverter-defibrillator; EF, ejection fraction; PES, programmed electrical stimulation; PP, primary prevention; SP, secondary prevention; VF, ventricular flutter or fibrillation; VT, ventricular tachycardia
Figure 2
Figure 2
Kaplan-Meier curves of event-free survival in patients with induced ventricular tachycardia and ventricular flutter or fibrillation during programmed electrical stimulation. MVT, monomorphic ventricular tachycardia; PVT/VF, polymorphic ventricular tachycardia/fibrillation.
See this image and copyright information in PMC

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References

    1. AVID Investigators. A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators. N Engl J Med 1997;337:1576–83. - PubMed
    1. Moss AJ, Hall WJ, Cannom DS, et al. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. N Engl J Med 1996;335:1933–40. - PubMed
    1. Buxton AE, Lee KL, Fisher JD, et al. A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. N Engl J Med 1999;341:1882–90. - PubMed
    1. Wellens HJ, Brugada P, Stevenson WG. Programmed electrical stimulation of the heart in patients with life-threatening ventricular arrhythmias: what is the significance of induced arrhythmias and what is the correct stimulation protocol? Circulation 1985;72:1–7. - PubMed
    1. Brugada P, Green M, Abdollah H, et al. Significance of ventricular arrhythmias initiated by programmed ventricular stimulation: the importance of the type of ventricular arrhythmia induced and the number of premature stimuli required. Circulation 1984;69:87–92. - PubMed

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