Key result
A negative electrophysiology study in STEMI patients with severe LV dysfunction predicted 93.4% survival free of death or arrhythmia at 3 years, versus 62.7% in EPS-positive patients (P<0.001).
Why the study?
Does a negative electrophysiology study identify post-STEMI patients with severe left ventricular dysfunction who have favorable long-term arrhythmia-free survival without an implantable cardioverter-defibrillator?
Cohort (n=1,414)
Does a negative electrophysiology study identify post-STEMI patients with severe left ventricular dysfunction who have favorable long-term arrhythmia-free survival without an implantable cardioverter-defibrillator?
Absolute Event Rate: 93.4% vs 62.7%
p-value: p=<0.001
A negative electrophysiology study early after STEMI identifies a subgroup of patients with severe left ventricular dysfunction who have a favorable long-term prognosis without an implantable cardioverter-defibrillator, comparable to patients with preserved LVEF.
No takes yet. Share an insight, caveat, or question.
May support selective ICD deferral after negative EPS in post-STEMI LVEF ≤40%; hypothesis-generating and requires randomized confirmation.
Zaman et al. (2014) conducted a cohort in ST-segment-elevation myocardial infarction with severely impaired left ventricular function (n=1,414). Negative electrophysiology study (no inducible ventricular tachycardia) vs. Positive electrophysiology study (inducible monomorphic ventricular tachycardia) was evaluated on Survival free of death or arrhythmia (resuscitated cardiac arrest or sustained ventricular tachycardia/ventricular fibrillation) (p=<0.001). A negative electrophysiology study in STEMI patients with severe LV dysfunction predicted 93.4% survival free of death or arrhythmia at 3 years, versus 62.7% in EPS-positive patients (P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: