Importance of programmed ventricular stimulation in patients with ventricular salvos

The yield of programmed ventricular stimulation in asymptomatic patients with documented ventricular salvoes is not definitely known. Therefore, we retrospectively evaluated the data of 57 patients in whom ventricular salvoes had been observed, either during resting ECG or 24-hour ECG monitoring, and who had been studied using programmed ventricular stimulation. Of these patients, 63% were male, with a mean age of 49 years. 28% had coronary artery disease, 21% dilated cardiomyopathy, 16% mitral valve prolapse, 9% hypertrophic cardiomyopathy, 9% valvular heart disease and 14% had no structural heart disease. Using a maximum of two premature ventricular extrastimuli during programmed ventricular stimulation, sustained ventricular tachycardia or ventricular fibrillation was induced in nine patients (16%). In 30 patients (53%) nonsustained ventricular tachycardia was induced (3-35 ventricular echo beats), in 18 patients only one to two ventricular echo beats could be induced. In 8/16 patients (50%) with coronary artery disease, sustained ventricular tachycardia/ventricular fibrillation could be induced. Mean left ventricular ejection fraction did not differ between patients with inducible sustained ventricular tachyarrhythmia and those with inducible non-sustained ventricular tachycardia or those with a normal result during programmed ventricular stimulation. 33 patients were treated with antiarrhythmic drugs; the efficacy of antiarrhythmic therapy was either controlled by "serial electrophysiologic testing" in four patients, or by repeated 24-hour long-term ECG in 29 patients. During a mean follow-up period of 31 +/- 24 months five patients died, two of them suddenly. None of the remaining patients had experienced a symptomatic sustained ventricular tachycardia or a syncope.(ABSTRACT TRUNCATED AT 250 WORDS)