Copyright © 1994 by the European Society of Cardiology.
© 1994 The European Society of Cardiology
Role of programmed ventricular stimulation in patients with idiopathic dilated cardiomyopathy and documented sustained ventricular tachyarrhythmias: inducibility and prognostic value in 102 patients
Hospital of the Westfälische Wilhems-University of M
nster, Department of Cardiologyl Angiology and Institute for Research in Atherosclerosis Mnster, Germany
Received 26 February 1993; revised 14 July 1993; .
Correspondence: Dr Xu Chen, Westfälische Wilhelms Universitat, Medizinische Klinik und Poliklinik, Innere Medizin C, Albert-Schweitzer-Str 33, 48149 Mnster, Germany
Abstract
The role of programmed ventricular stimulation (PVS) in patients at high risk of sudden death related to idiopathic dilated cardiomyopathy (DCM) is still controversial The possible reason is that most study series have been too small or that only a few patients had documented sustained ventricular tachyarrhythmias.
This study therefore, looked at PVS performed in 102 patients with DCM and documented sustained ventricular tachycardia (VT; n=63) or ventricular fibrillation (VF; n=39). Sustained VT was induced in 27 of 63 patients (43%) with documented sustained VT and in 14 of 39 patients (36%) with documented VF (ns). VF was induced in nine patients (14%) with a history of sustained VT and in seven (18%) with a history of VF (ns). At a mean follow-up of 32±15 months, sudden death occurred in 14 (14%) patients, a rate similar in both patients with documented VT and VF (ns). Incidence of sudden death at 36 months was 6% in patients with inducible sustained VT/VF compared to 29% in patients without inducible VT/VF (P<0·05) A favourable drug regimen (response to drug and no intolerable side effects) was obtained by serial drug testing in 25 of all 102 patients (25%). A cardioverter defibrillator (ICD) was implanted in 32 patients, in 63% of whom discharges were observed during 18±11 months of follow-up; only one patient (3%) died suddenly.
Thus, in patients with DCM, there was no relationship between documented and inducible ventricular tachzyarrhythmias, and initiation of sustained VT or VF had little prognostic value for the prediction of subsequent sudden death.
Wherever antiarrhythmic drug therapy was of limited value, implantation of an ICD may improve the prognosis of these high risk patients.
Key Words: Idiopathic dilated cardiomyopathy • programmed ventricular stimulation • sudden death • implantable cardioverter defibrillator
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  Authors/Task Force Members, P. E. Vardas, A. Auricchio, J.-J. Blanc, J.-C. Daubert, H. Drexler, H. Ector, M. Gasparini, C. Linde, F. B. Morgado, et al. Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association Europace, October 1, 2007; 9(10): 959 - 998. [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, P. E. Vardas, A. Auricchio, J.-J. Blanc, J.-C. Daubert, H. Drexler, H. Ector, M. Gasparini, C. Linde, F. B. Morgado, et al. Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association Eur. Heart J., September 2, 2007; 28(18): 2256 - 2295. [Full Text] [PDF]
|
|
|
|
 |
|
 S. H. Hohnloser, T. Klingenheben, D. Bloomfield, O. Dabbous, and R. J. Cohen Usefulness of microvolt T-wave alternans for prediction of ventricular tachyarrhythmic events in patients with dilated cardiomyopathy: results from a prospective observational study J. Am. Coll. Cardiol., June 18, 2003; 41(12): 2220 - 2224. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Verrier, A. V. Tolat, and M. E. Josephson T-Wave alternans for arrhythmia risk stratification in patients with idiopathic dilated cardiomyopathy J. Am. Coll. Cardiol., June 18, 2003; 41(12): 2225 - 2227. [Full Text] [PDF]
|
|
|
|
|
|
D. Bansch, D. Bocker, J.u. Brunn, M. Weber, G.u. Breithardt, and M. Block Clusters of ventricular tachycardias signify impaired survival in patients with idiopathic dilated cardiomyopathy and implantable cardioverter defibrillators J. Am. Coll. Cardiol., August 1, 2000; 36(2): 566 - 573. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Martinez-Rubio, Y. Schwammenthal, E. Schwammenthal, M. Block, L. Reinhardt, A. Garcia-Alberola, G. Sierra, M. Shenasa, W. Haverkamp, H. H. Scheld, et al. Patients With Valvular Heart Disease Presenting With Sustained Ventricular Tachyarrhythmias or Syncope : Results of Programmed Ventricular Stimulation and Long-term Follow-up Circulation, July 15, 1997; 96(2): 500 - 508. [Abstract] [Full Text]
|
|
|
|
|
|
H. Kottkamp, G. Hindricks, X. Chen, J. Brunn, S. Willems, W. Haverkamp, M. Block, G. Breithardt, and M. Borggrefe Radiofrequency Catheter Ablation of Sustained Ventricular Tachycardia in Idiopathic Dilated Cardiomyopathy Circulation, September 1, 1995; 92(5): 1159 - 1168. [Abstract] [Full Text]
|
|