Premium
Role of Programmed Ventricular Stimulation and Implantable Cardioverter Defibrillators in Patients with Idiopathic Dilated Cardiomyopathy and Syncope
Author(s) -
BRILAKIS EMMANOUIL S.,
SHEN WIN K.,
HAMMILL STEPHEN C.,
HODGE DAVID O.,
REA ROBERT F.,
LEXVOLD NANCY Y.,
FRIEDMAN PAUL A.
Publication year - 2001
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2001.01623.x
Subject(s) - medicine , presyncope , cardiology , dilated cardiomyopathy , ventricular tachycardia , syncope (phonology) , cardiomyopathy , heart rate , heart failure , blood pressure
BRILAKIS, E.S., et al. : Role of Programmed Ventricular Stimulation and Implantable Cardioverter Defibrillators in Patients with Idiopathic Dilated Cardiomyopathy and Syncope. The aim of this study was to evaluate the role of programmed ventricular stimulation and ICDs in patients with idiopathic dilated cardiomyopathy and syncope. Between 1990 and 1998, 54 (mean age 67 ± 11 years, 76% men) patients presented with idiopathic dilated cardiomyopathy and syncope. An electrophysiological study was done in 37 of the 54 patients: 10 had inducible sustained monomorphic ventricular tachycardia, 12 had conduction system disease or neurocardiogenic syncope, and 15 had a normal study. Overall, 17 patients received an ICD, 15 patients received a pacemaker, and 22 patients received no device. Nine of the 15 patients with a negative electrophysiological study eventually received an ICD: 3 because they were considered high risk and 6 because of recurrent syncope or presyncope. In the 17 patients who received an ICD, incidence of appropriate shocks at 1 and 3 years was 47% and 74%, respectively, in the inducible sustained monomorphic ventricular tachycardia group, and 40% and 40%, respectively, in the group without inducible sustained monomorphic ventricular tachycardia ( P = 0.29 , log‐rank test). In conclusion, programmed ventricular stimulation is not useful in risk stratification of patients with idiopathic dilated cardiomyopathy and syncope and may delay necessary ICD implantation.