Inducible VT at electrophysiological study was the best predictor of spontaneous VT and sudden death after myocardial infarction, making patients 15.2 times more likely to suffer electrical events.
Cohort (n=361)
Does inducible VT predict spontaneous ventricular tachycardia and sudden death in patients after myocardial infarction?
Inducible VT during electrophysiological study is the strongest predictor of spontaneous VT and sudden death within the first year post-myocardial infarction.
Effect estimate: 15.2 times more likely
BACKGROUND: Death during the first year after myocardial infarction is most commonly due to spontaneous ventricular tachycardia (VT) or fibrillation (VF). The purpose of this study was to compare, in a single cohort of patients, the values of inducible VT, delayed ventricular activation, low left ventricular ejection fraction, high-grade ventricular ectopy, and ST segment displacement on exercise in predicting electrical events (witnessed instantaneous death and spontaneous VT or VF) during the first year after myocardial infarction. METHODS AND RESULTS: Three hundred sixty one patients aged less than 71 years underwent electrophysiological study, signal-averaged electrocardiogram, gated blood-pool scan, 24 hour ambulatory electrocardiographic monitoring, and exercise testing 1-2 weeks after myocardial infarction and were then followed up for at least 1 year. There were 34 deaths (eight witnessed instantaneous, 26 other), and nine patients survived one or more episodes of spontaneous VF or VT. Patients with inducible VT were 15.2 times more likely to suffer electrical events than patients without inducible VT. No proportional-hazards model excluding inducible VT was as good a predictor of electrical events as was inducible VT alone. CONCLUSIONS: Inducible VT at electrophysiological study was the single best predictor of spontaneous VT and sudden death after myocardial infarction.
Richards et al. (Fri,) conducted a cohort in myocardial infarction (n=361). Inducible VT at electrophysiological study vs. No inducible VT was evaluated on Electrical events (witnessed instantaneous death and spontaneous VT or VF) during the first year (15.2 times more likely). Inducible VT at electrophysiological study was the best predictor of spontaneous VT and sudden death after myocardial infarction, making patients 15.2 times more likely to suffer electrical events.