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Background The clinical significance of the duration of inducible ventricular tachycardia (VT ) at electrophysiology study (EPS ) in patients soon afterST ‐segment–elevation myocardial infarction and its predictive utility forVT recurrence are not known.Methods and Results ConsecutiveST ‐segment–elevation myocardial infarction patients with day 3 to 5 left ventricular ejection fraction ≤40% underwentEPS . A positiveEPS was defined as sustained monomorphicVT with cycle length ≥200 ms. The inducedVT was terminated by overdrive pacing or direct current shock at 30 s or earlier if hemodynamic decompensation occurred. Patients with inducibleVT duration 2 to 10 s were compared with patients with inducibleVT &gt;10 s. The primary end point was survival free ofVT or cardiac mortality. From 384 consecutiveST ‐segment–elevation myocardial infarction patients who underwentEPS , 29% had inducibleVT (n=112, 87% men). After mean follow‐up of 5.9±3.9 years, primary end point occurred in 35% of patients with inducedVT 2 to 10 s duration (n=68) and in 22% of patients with inducedVT &gt;10 s (n=41) (P =0.61). This was significantly different from the noninducibleVT group, in which primary end point occurred in 3% of patients (n=272) (P =0.001).Conclusions This study is the first to show that in patients who undergoEPS early after myocardial infarction, inducibleVT of short duration (2–10 s) has similar predictive utility for ventricular tachyarrhythmia as longer duration (&gt;10 s) inducibleVT , which was significantly different to those without inducibleVT . It is possible that immediate cardioversion of rapidVT might have contributed to some of the short durations of inducibleVT .

journal of the american heart association. cardiovascular and cerebrovascular disease

Duration of Inducible Ventricular Tachycardia Early After ST‐Segment–Elevation Myocardial Infarction and Its Impact on Mortality and Ventricular Tachycardia Recurrence