Key result
Very large myocardial scar predicts sustained VT inducibility on EPS in ~78% of patients.
Why the study?
Few data are available concerning the relationship between myocardial scar and ischemia and arrhythmic potential in patients with coronary artery disease.
Does myocardial scar or ischemia size on MPI predict inducibility of sustained ventricular tachycardia on electrophysiological study in patients with coronary artery disease?
Comparison
Myocardial scar (fixed defect) vs ischemia (reversible defect) in relation to inducibility on EPS
Design
Observational cohort study
Authors
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Scar size on MPI may refine VT risk assessment in CAD; hypothesis-generating and requires prospective validation before clinical use.
Observational (n=144)
Does myocardial scar or ischemia size on MPI predict inducibility of sustained ventricular tachycardia on electrophysiological study in patients with coronary artery disease?
Absolute Event Rate: 78% vs 30%
p-value: p=< 0.0001
Myocardial scar size, but not ischemia, quantified by myocardial perfusion imaging is an independent predictor of sustained ventricular tachycardia inducibility on electrophysiological study in patients with coronary artery disease.
Grädel et al. (1997) conducted an observational in chronic coronary artery disease (n=144). Very large myocardial scar (defect integral > 30) vs. Small myocardial scar (defect integral < 5) was evaluated on Inducibility of sustained monomorphic ventricular tachycardia on EPS (p=< 0.0001). Myocardial scar size was an independent predictor of sustained VT inducibility on EPS, with 78% of patients with very large defects being inducible compared to 30% of those with small defects.
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