Clinical significance of ventricular fibrillation-flutter induced by ventricular programmed stimulation.

Abstract:

:Two hundred twenty-four patients underwent ventricular programmed stimulation (VPS) without prior documentation of the clinical occurrence of sustained ventricular tachycardia (VT) or ventricular fibrillation-flutter (VF). Indications for VPS were: palpitations or nonsustained VT during ambulatory monitoring (85 patients), syncope or presyncope (137 patients), and a family history of sudden death (two patients). Sustained VF requiring transthoracic defibrillation was initiated by VPS in 18 patients (8.0%). Four patients were treated for inducible VF with antiarrhythmic agents directed by electropharmacologic testing; five patients were treated empirically; nine patients received no therapy. No patient has had a cardiac arrest or sudden death during a follow-up period 25.2 +/- 13.8 months (mean +/- standard deviation). VF was initiated by two ventricular extrastimuli in three patients and by three extrastimuli in 15 patients. The incidence of VF was similar in patients with and without previous symptoms (8.8% vs 6.9%) or heart disease (7.1% vs 9.6%). It was significantly higher when VPS at three ventricular sites with a current of 5 mA (pulse width 2 msec) was compared to programmed stimulation at two ventricular sites with a current twice diastolic threshold (pulse width 2 msec) (15.2% vs 3.0%, p less than 0.05). VF initiated by VPS in patients without prior VT or VF appears to be a nonspecific finding. Antiarrhythmic therapy for VF may not be necessary in these patients.

journal_name

Am Heart J

journal_title

American heart journal

authors

DiCarlo LA Jr,Morady F,Schwartz AB,Shen EN,Baerman JM,Krol RB,Scheinman MM,Sung RJ

doi

10.1016/0002-8703(85)90235-2

subject

Has Abstract

pub_date

1985-05-01 00:00:00

pages

959-63

issue

5 Pt 1

eissn

0002-8703

issn

1097-6744

pii

0002-8703(85)90235-2

journal_volume

109

pub_type

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