What does this research mean for the field?

Noninducible ventricular tachycardia during electrophysiological testing and abolition of ventricular tachycardia during Holter monitoring are equally predictive of long-term amiodarone success, although electrophysiological testing using triple extrastimuli provides the highest predictive value. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To compare the ability of invasive electrophysiological testing versus noninvasive Holter monitoring to predict long-term amiodarone efficacy in patients with sustained ventricular tachycardia.

October 1, 1994Pacing and Clinical Electrophysiology

Invasive and Noninvasive Methods to Predict the Long‐Term Efficacy of Amiodarone: A Compilation of Clinical Observations Using Meta‐Analysis

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Why the study?

Does electrophysiological testing better predict long-term amiodarone efficacy compared to Holter monitoring in patients with sustained ventricular tachycardia?

Population

518 patients with sustained ventricular tachycardia treated with amiodarone from 12 studies

Comparison

Electrophysiological testing to predict… vs Holter monitoring to predict amiodarone efficacy

Design

Meta-analysis

Follow-up

long-term

Authors

SRSheila A. RobertsChicago Department of Public Health MVMarlos A. G. VianaOregon State University JNJose NazariEndeavor Charter School

Discussion

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Implication

EP testing with triple extrastimuli may better guide amiodarone use in sustained VT than Holter; extends meta-analytic support for invasive prediction.

Key Points

To compare the ability of invasive electrophysiological testing versus noninvasive Holter monitoring to predict long-term amiodarone efficacy in patients with sustained ventricular tachycardia.
Conducted a meta-analysis combining arrhythmia recurrence data across 9 electrophysiological testing studies (N=351) and 3 Holter monitoring studies (N=167) identified via predefined criteria.
Calculated Bayesian estimates and 95% credibility intervals to evaluate the probability of remaining arrhythmia-free, with subgroup analysis based on electrophysiological stimulation protocols.
The overall estimated arrhythmia-free probability was 0.86 (95% CI, 0.78–0.92) for patients rendered noninducible on electrophysiological testing versus 0.81 (95% CI, 0.73–0.87) for those with ventricular tachycardia abolition on Holter monitoring.
Restricting electrophysiological analyses to protocols using at least triple extrastimuli significantly increased the arrhythmia-free probability to 0.96 (95% CI, 0.88–0.99), demonstrating superior predictive power over noninvasive Holter monitoring.

Structured PICO

Does electrophysiological testing better predict long-term amiodarone efficacy compared to Holter monitoring in patients with sustained ventricular tachycardia?

Population

518 patients with sustained ventricular tachycardia treated with amiodarone from 12 studies (9 studies using electrophysiological testing with 351 patients, and 3 studies using Holter monitoring with 167 patients)

Intervention

Electrophysiological testing to predict amiodarone efficacy (specifically assessing noninducibility of ventricular tachycardia)

Comparator

Holter monitoring (electrocardiographic monitoring) to predict amiodarone efficacy (specifically assessing abolition of ventricular tachycardia)

Outcome

Arrhythmia-free probability (arrhythmia recurrence)hard clinical

Electrophysiological testing using triple extrastimuli is highly predictive of long-term amiodarone efficacy in patients with sustained ventricular tachycardia, outperforming Holter monitoring.

Cite This Study

Roberts et al. (1994) studied this question.

synapsesocial.com/papers/6a1bdecc666b677c61a900bf https://doi.org/10.1111/j.1540-8159.1994.tb02352.x

Topics

Ventricular arrhythmias

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Implication

EP testing with triple extrastimuli may better guide amiodarone use in sustained VT than Holter; extends meta-analytic support for invasive prediction.

Invasive and Noninvasive Methods to Predict the Long‐Term Efficacy of Amiodarone: A Compilation of Clinical Observations Using Meta‐Analysis

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Invasive and Noninvasive Methods to Predict the Long‐Term Efficacy of Amiodarone: A Compilation of Clinical Observations Using Meta‐Analysis

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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