What does this research mean for the field?

Programmed ventricular stimulation does not effectively risk-stratify patients with idiopathic dilated cardiomyopathy presenting with syncope, as rates of appropriate ICD shocks do not significantly differ based on ventricular tachycardia inducibility. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

November 1, 2001Pacing and Clinical Electrophysiology

Role of Programmed Ventricular Stimulation and Implantable Cardioverter Defibrillators in Patients with Idiopathic Dilated Cardiomyopathy and Syncope

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Idiopathic dilated cardiomyopathy and syncope (n=54). Intervention: Inducible sustained monomorphic ventricular tachycardia during programmed ventricular stimulation vs. No inducible sustained monomorphic ventricular tachycardia. Primary outcome: Incidence of appropriate ICD shocks at 3 years (p=0.29).

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Key result

Inducible VT fails to predict appropriate ICD shocks in idiopathic DCM with syncope.

P=0.29
n=54

Why the study?

The role of programmed ventricular stimulation and ICDs in patients with idiopathic dilated cardiomyopathy and syncope was unclear.

Does programmed ventricular stimulation predict appropriate ICD shocks in patients with idiopathic dilated cardiomyopathy and syncope?

Population

54 patients with idiopathic dilated cardiomyopathy and syncope, mean age 67+/-11 years, 76% men

Design

Cohort study

Follow-up

3 years

Authors

EBEmmanouil S. BrilakisInterventional Cardiology WSWin K. ShenWinnMed SHStephen C. HammillElectrophysiology

Discussion

Member takes

Implication

Caution advised against routine EPS-guided ICDs in DCM with syncope; leaves open need for prospective trials.

Study Design

Type

Cohort (n=54)

Structured PICO

Does programmed ventricular stimulation predict appropriate ICD shocks in patients with idiopathic dilated cardiomyopathy and syncope?

Population

54 patients (mean age 67 years, 24% female) with idiopathic dilated cardiomyopathy and syncope, evaluated between 1990 and 1998.

Exposure

Programmed ventricular stimulation (electrophysiological study) and Implantable Cardioverter Defibrillator (ICD) implantation

Comparator

Patients with vs without inducible sustained monomorphic ventricular tachycardia during electrophysiological study

Outcome

Incidence of appropriate ICD shocks at 1 and 3 yearshard clinical

Main Result

Absolute Event Rate: 74% vs 40%

p-value: p=0.29

Programmed ventricular stimulation is not useful for risk stratification in patients with idiopathic dilated cardiomyopathy and syncope and may unnecessarily delay ICD implantation.

Cite This Study

Brilakis et al. (2001) conducted a cohort in Idiopathic dilated cardiomyopathy and syncope (n=54). Inducible sustained monomorphic ventricular tachycardia during programmed ventricular stimulation vs. No inducible sustained monomorphic ventricular tachycardia was evaluated on Incidence of appropriate ICD shocks at 3 years (p=0.29). In patients with idiopathic dilated cardiomyopathy and syncope receiving an ICD, the incidence of appropriate shocks at 3 years was 74% with inducible VT versus 40% without (P=0.29).

synapsesocial.com/papers/6ab7416b7e2508a9a6fb90e6 https://doi.org/10.1046/j.1460-9592.2001.01623.x

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Role of Programmed Ventricular Stimulation and Implantable Cardioverter Defibrillators in Patients with Idiopathic Dilated Cardiomyopathy and Syncope

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Role of Programmed Ventricular Stimulation and Implantable Cardioverter Defibrillators in Patients with Idiopathic Dilated Cardiomyopathy and Syncope

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider