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Programmed ventricular stimulation in patients with idiopathic dilated cardiomyopathy and syncope receiving implantable cardioverter-defibrillators: a case series and a systematic review of the literature.

Abstract：

BACKGROUND:The role of programmed ventricular stimulation (PVS) in patients with idiopathic dilated cardiomyopathy (DCM) and syncope receiving implantable cardioverter-defibrillators (ICD) remains controversial. METHODS AND RESULTS:Between 1994 and July 2002, 20 patients with DCM and syncope underwent PVS and ICD implantation at the Onassis Cardiac Surgery Center or the Alexandra General Hospital. At PVS 10 patients had inducible sustained monomorphic ventricular tachycardia (SMVT), 3 patients had inducible sustained polymorphic ventricular tachycardia or ventricular fibrillation, and 7 patients had no inducible arrhythmia. The latter 7 patients received an ICD because of clinical occurrence of ventricular tachycardia (n=5) or fibrillation (n=2). Mean age was 55+/-14 years; 80% were men. During a mean follow-up of 2.8+/-2.3 years, 12 of the 20 patients received an appropriate shock. The incidence of appropriate shocks at 1 and 3 years was 69% and 84% in the inducible SMVT group, and 56% and 67% in the group without inducible SMVT (p=0.93, log rank test). Overall survival was similar in both groups (p=0.53). In a systematic review of the published literature 18 of 75 (24%) patients with DCM, syncope and a negative PVS had an appropriate ICD shock after a mean follow-up of 27 months. CONCLUSION:PVS has a limited role in risk stratification of patients with DCM and syncope.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Brilakis ES,Friedman PA,Maounis TN,Rokas SG,Shen WK,Stamatelopoulos SF,Cokkinos DV

doi

10.1016/j.ijcard.2003.12.012

subject

Has Abstract

pub_date

2005-02-28 00:00:00

pages

395-401

issue

3

eissn

0167-5273

issn

1874-1754

pii

S0167527304000804

journal_volume

98

pub_type

杂志文章,多中心研究,评审

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