What is the clinical evidence from this study?

Study design: Cohort. Population: Coronary artery disease and left ventricular dysfunction with life-threatening ventricular arrhythmias (n=103). Intervention: ≥8 fixed perfusion defects on SPECT vs. <8 fixed perfusion defects. Primary outcome: Death (p=0.005).

What does this research mean for the field?

In patients with life-threatening ventricular arrhythmias treated with an implantable cardioverter-defibrillator, the extent of myocardial scar on SPECT perfusion imaging independently predicts mortality, with eight or more fixed defects associated with a 2.7-fold higher risk of death. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 21, 1997Circulation

Prediction of Outcome of Patients With Life-Threatening Ventricular Arrhythmias Treated With Automatic Implantable Cardioverter-Defibrillators Using SPECT Perfusion Imaging

Q: What are the key findings of this study?

In patients with life-threatening ventricular arrhythmias treated with an ICD, having ≥8 fixed perfusion defects on SPECT was associated with a higher death rate than <8 defects (38% vs 14%, P=0.005).

Q: What does this research mean for the field?

In patients with life-threatening ventricular arrhythmias treated with an implantable cardioverter-defibrillator, the extent of myocardial scar on SPECT perfusion imaging independently predicts mortality, with eight or more fixed defects associated with a 2.7-fold higher risk of death. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

≥8 fixed SPECT perfusion defects are linked to ~171% higher mortality in ICD patients.

P=0.005
n=103

Why the study?

Does the extent of myocardial scarring on SPECT perfusion imaging predict cardiac death in patients with CAD, LV dysfunction, and life-threatening ventricular arrhythmias treated with an ICD?

Population

103 patients with coronary artery disease and left ventricular dysfunction who had life-threatening…

Design

Cohort

Follow-up

mean 29 months

Authors

GGGiuseppe Di GioiaMercy Clinic Neurology BBBruce BagheriAllegheny College CGCharles GottliebCentre National de la Recherche Scientifique

Discussion

Member takes

Implication

SPECT scar burden may refine mortality risk stratification in ICD patients; leaves open whether it should guide therapy pending prospective validation.

Study Design

Type

Cohort (n=103)

Structured PICO

Does the extent of myocardial scarring on SPECT perfusion imaging predict cardiac death in patients with CAD, LV dysfunction, and life-threatening ventricular arrhythmias treated with an ICD?

Population

103 patients with coronary artery disease, left ventricular dysfunction, and life-threatening ventricular arrhythmias treated with implantable cardioverter-defibrillators, followed for a mean of 29 months.

Exposure

SPECT perfusion imaging (assessment of fixed perfusion defects/scarring)

Outcome

Cardiac deathhard clinical

Main Result

Absolute Event Rate: 38% vs 14%

p-value: p=0.005

The extent of myocardial scarring assessed by SPECT perfusion imaging is a strong independent predictor of cardiac death in patients with CAD and LV dysfunction treated with an ICD for life-threatening ventricular arrhythmias.

Cite This Study

Gioia et al. (1997) conducted a cohort in Coronary artery disease and left ventricular dysfunction with life-threatening ventricular arrhythmias (n=103). ≥8 fixed perfusion defects on SPECT vs. <8 fixed perfusion defects was evaluated on Death (p=0.005). In patients with life-threatening ventricular arrhythmias treated with an ICD, having ≥8 fixed perfusion defects on SPECT was associated with a higher death rate than <8 defects (38% vs 14%, P=0.005).

synapsesocial.com/papers/6aa84911ebec0848581e94f2 https://doi.org/10.1161/01.cir.95.2.390

Topics

Cardiac device therapy

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Implication

SPECT scar burden may refine mortality risk stratification in ICD patients; leaves open whether it should guide therapy pending prospective validation.

Prediction of Outcome of Patients With Life-Threatening Ventricular Arrhythmias Treated With Automatic Implantable Cardioverter-Defibrillators Using SPECT Perfusion Imaging

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Prediction of Outcome of Patients With Life-Threatening Ventricular Arrhythmias Treated With Automatic Implantable Cardioverter-Defibrillators Using SPECT Perfusion Imaging

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider