Why the study?
Does electrophysiologic study predict outcomes in patients with nonsustained ventricular tachycardia?
Does electrophysiologic study predict outcomes in patients with nonsustained ventricular tachycardia?
In patients with nonsustained VT, the prognosis is generally good with no cardiac deaths over 31 months, suggesting limited clinical utility for routine electrophysiologic testing in this population.
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Low event rate despite inducibility in nonsustained VT; leaves open electrophysiologic study's prognostic value.
Electrophysiologic study (EPS) was performed in 68 consecutive patients with nonsustained ventricular tachycardia (VT) detected by ambulatory monitoring. The study group consisted of 11 patients with coronary artery disease, 11 patients with idiopathic cardiomyopathy or myocarditis, 2 patients with valvular heart disease, 1 patient with post atrial septal defect repair and 43 patients with a normal heart. Syncope or presyncope was found in 34 percent of these patients. EPS was performed after all antiarrhythmic drugs were withdrawn for more than 5 days. Nonsustained VT, sustained VT, and ventricular fibrillation were induced in 21%, 4%, and 4% respectively. VT was induced more frequently in patients with organic heart diseases but it was not related to the history of syncope. Ejection fraction in the inducible patients was not different from that of the noninducible patients. During the mean follow up period of 31 months, there was no cardiac death. The results suggest that the prognosis of patients with nonsustained VT is good and the clinical significance of their EPS findings seems to be limited.
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Takahashi et al. (1994) studied this question.
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