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Survival After A First Episode of Ventricular Tachycardia or Fibrillation
Author(s) -
PINSKI SERGIO L.,
MALONEY JAMES D.,
SGARBOSSA ELENA B.,
JUBRAN FUAD,
TROHMAN RICHARD G.
Publication year - 1992
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.1540-8159.1992.tb03042.x
Subject(s) - medicine , ventricular fibrillation , cardiology , ventricular tachycardia , tachycardia , atrial fibrillation
Recent outcome analyses in ventricular tachycardia (VT) and ventricular fibrillation (VF) have included patients undergoing electrophysiological study (EPS) at tertiary care centers. The selection process involved could introduce bias in the reported populations. We analyzed the outcome of 42 consecutive patients (aged 63 ± 11 years) admitted to a coronary care unit within 48 hours of a first episode of VT/VF not associated with reversible causes. All patients recovered neurologically and were candidates for EPS. Nine patients (21%) died during the initial hospitalization (none had EPS), and another nine died during a follow‐up of 17 ± 12 months. Actuarial survival at 1 and 2 years was 64% and 62%, respectively. By Cox's model, congestive heart failure functional Class III‐IV (P = 0.008; hazard ratio = 3.7) was the only independent prognostic factor. Among patients discharged, subsequent survival did not depend on the performance of EPS or on the antiarrhythmic therapeutic modalities used. Mortality after a first episode of VT/VF is high. Severe congestive heart failure is the most powerful prognostic factor. Studies including successfully referred patients undergoing EPS may not reflect the true natural history of patients with VT/VF.