Value of electrophysiologic testing in patients with nonsustained ventricular tachycardia |
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| Authors: | A M Sulpizi T D Friehling P R Kowey |
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| Affiliation: | 1. The Baker Heart & Diabetes Institute, Clinical Electrophysiology Research, Melbourne, Australia;2. The Heart Centre, The Alfred Hospital, Melbourne, Australia;3. Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia;4. Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia;5. Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia;6. MonashHeart, Monash Medical Centre, Melbourne, Australia;1. Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan;2. Center for Clinical and Translational Research of Kyushu University Hospital, Fukuoka, Japan;3. Division of Cardiology, Japanese Red-Cross Fukuoka Hospital, Fukuoka, Japan;4. Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan;5. Department of Advanced Cardiopulmonary Failure, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;6. School of Medicine and Graduate School, International University of Health and Welfare, Otawara, Japan;1. Division of Cardiovascular Medicine, University of Louisville, Louisville, Kentucky;2. Division of Pediatric Cardiology, University of Utah, Salt Lake City, Utah;3. Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania;4. Department of Internal Medicine, University of South Carolina, Charleston, South Carolina;6. Division of Cardiology, University of Kansas, Kansas City, Kansas;5. Mercy Heart and Vascular Institute, Mercy Medical Center North Iowa, Mason City, Iowa |
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| Abstract: | This study was undertaken to determine the value of electrophysiologic testing in 61 patients with nonsustained ventricular tachycardia (VT) (3 or more beats) on ambulatory monitoring and no history of sustained ventricular arrhythmia. The study group consisted of 38 patients with coronary artery disease (CAD), 9 with idiopathic dilated cardiomyopathy and 14 with a normal heart. Nonsustained VT (at least 3 but not more than 15 beats) was induced in 46%, sustained VT (more than 15 beats) in 15% and no VT in 39%. Sustained VT was induced more frequently in the presence of left ventricular dysfunction (p = 0.005) but was not related to the presence of CAD. Over a mean follow-up of 26 months, 10 patients died from cardiac causes (4 suddenly), including 1 patient with inducible sustained VT, 2 with nonsustained VT and 7 with no inducible VT. Inducibility was not related to survival, either as a single variable or when combined with CAD, left ventricular dysfunction or recent myocardial infarction. Left ventricular function alone was a good predictor of outcome. Of 46 patients with an ejection fraction of 35% more or in New York Heart Association functional class I or II, 3 (7%) died from cardiac causes, compared with 7 of 13 patients (54%) with an ejection fraction of less than 35% or in functional class III or IV (p = 0.0001). Thus, in patients with nonsustained VT, the incidence of sustained VT during electrophysiologic testing is low and is related to the degree of left ventricular dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS) |
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