Use of electrophysiologic testing in patients with nonsustained ventricular tachycardia: prognostic and therapeutic implications.

Abstract:

:Forty patients with coronary artery disease and nonsustained ventricular tachycardia on ambulatory electrocardiographic monitoring underwent programmed electrical stimulation. In 22 patients, monomorphic ventricular tachycardia was induced at baseline drug-free electrophysiologic testing; 9 of these patients subsequently developed a clinical sustained ventricular tachyarrhythmia. In 18 patients, no tachycardia could be induced, and none of these 18 had subsequent tachycardia. In 25 of the 40 patients, arrhythmia management was guided by the results of electrophysiologic testing; this group included 11 patients who received antiarrhythmic therapy for induced ventricular tachycardia and 14 patients without inducible ventricular tachycardia who did not receive antiarrhythmic therapy. In the remaining 15 patients, arrhythmia management was not based on the results of electrophysiologic testing. Only two episodes of clinical sustained tachyarrhythmia occurred in the group receiving electrophysiologically guided therapy compared with seven episodes in the group treated without electrophysiologic guidance (p less than 0.01). Thus, in patients with coronary artery disease with nonsustained ventricular tachycardia on ambulatory electrocardiography, electrophysiologic testing can identify those at high and low risk for subsequent clinical tachycardia events. Furthermore, results of such testing can be used to optimize arrhythmia management in these patients.

journal_name

J Am Coll Cardiol

authors

Klein RC,Machell C

doi

10.1016/0735-1097(89)90066-1

subject

Has Abstract

pub_date

1989-07-01 00:00:00

pages

155-61; discussion 162-3

issue

1

eissn

0735-1097

issn

1558-3597

pii

0735-1097(89)90066-1

journal_volume

14

pub_type

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