Programmed ventricular stimulation inducing tachyarrhythmias (in 23% of patients) did not significantly predict sudden death or spontaneous ventricular tachycardia during a 10-month follow-up.
Cohort (n=150)
Does programmed ventricular stimulation identify a high risk for sudden cardiac death in survivors of acute myocardial infarction?
Induction of ventricular tachyarrhythmias during programmed ventricular stimulation does not identify a high-risk group for sudden cardiac death among survivors of acute myocardial infarction.
The prognostic significance of programmed ventricular stimulation and its usefulness in relation to other forms of invasive and noninvasive testing was evaluated in 150 survivors of acute myocardial infarction. Ventricular tachyarrhythmias of 6 beats or more were induced in 35 (23%) patients. No significant differences existed between patients with inducible ventricular tachyarrhythmias and those without inducible ventricular tachycardia with respect to occurrence of spontaneous ventricular arrhythmias in the acute and early recovery phase of infarction or predischarge exercise-induced ischemia or arrhythmias, severity of coronary artery disease, or degree of left ventricular dysfunction. A higher incidence of inferior myocardial infarction was observed in patients with inducible ventricular tachycardia when compared with those without inducible ventricular tachycardia (66% vs 41%, p less than .01). During a mean follow-up of 10 +/- 5 months (range 2 to 19), there were two sudden deaths, three nonsudden deaths, and two additional patients developed sustained ventricular tachyarrhythmias. There was no significant difference between patients with and those without inducible ventricular tachyarrhythmias with respect to the occurrence of these events. In this study population, a lower mean ejection fraction (p less than .01), the presence of a ventricular aneurysm (p less than .05), and exercise-induced ventricular premature contractions (p less than .05) were predictors of sudden death and of spontaneous ventricular tachycardia. Thus, the findings of this study do not support the hypothesis that the induction of ventricular tachyarrhythmias in patients recovering from acute myocardial infarction identifies a group at high risk for sudden cardiac death.
Roy et al. (Sun,) conducted a cohort in Acute myocardial infarction (n=150). Programmed ventricular stimulation vs. No inducible ventricular tachyarrhythmias was evaluated on Sudden death, nonsudden death, and sustained ventricular tachyarrhythmias. Programmed ventricular stimulation inducing tachyarrhythmias (in 23% of patients) did not significantly predict sudden death or spontaneous ventricular tachycardia during a 10-month follow-up.