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Long‐Term Outcome Following Programmed Electrical Stimulation in Patients with High‐Grade Ventricular Ectopy
Author(s) -
KHARSA MOHAMED H.,
GOLD ROBERT L.,
MOORE HAROLD,
YAZAKI YOSHIZUMI,
HAFFAJEE CHARLES I.,
ALPERT JOSEPH S.
Publication year - 1988
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 - 10.1111/j.1540-8159.1988.tb04556.x
Subject(s) - medicine , cardiology , ventricular tachycardia , myocardial infarction , heart disease , sudden death , sudden cardiac death , incidence (geometry) , optics , physics
To determine if programmed electrical stimulation (PES) could be utilized to identify patients with high‐grade ventricular ectopy at low‐ or high‐risk for sudden cardiac death, we performed PES in 40 patients with high‐grade ventricular ectopy reactory to conventional antiarrhythmic agents. Twenty‐one patients had a previous myocardial infarction, five had cardiomyopathy, six had hypertension, three had valvular heart disease and five had no known structural heart disease. The mean age was 50 years (range, 18 to 76). During programmed ventricular stimulation, eight patients had inducible sustained (more than 30 seconds) monomorphic ventricular tachycardia (Group II but in 32 patients sustained ventricular tachycardia was not inducible (Group II). None of the five patients without structural heart disease were inducible while seven out of 21 (33%) patients with previous myocardial infarction had inducible ventricular tachycardia (VT). Antiarrhythmic therapy was instituted in patients with inducible VT; patients without inducible VT did not receive antiarrhythmic agents. In Group I, seven of the eight patients are alive (mean follow‐up, 16 months) and in Group 11, 28 of the 32 patients are alive (mean follow‐up, 17 months). None of the five deaths were sudden. We conclude that in the absence of antiarrhythmic therapy, the incidence of sudden cardiac death is very low in patients with high‐grade ventricular ectopy who do not have inducible monomorphic ventricular tachycardia during programmed ventricular stimulation.