We analyzed data from 239 patients with sustained ventricular tachycardia or ventricular fibrillation to determine prognosis, predictors of survival, and the prognostic value of inducing arrhythmia and assessing therapy at the time of electrophysiologic study. Therapy predicted to be effective on the basis of electrophysiologic study was administered over a sustained period. There were 71 cardiac deaths, including 44 sudden deaths, during a mean (+/- S.D.) follow-up period of 14.8 +/- 13.9 months (range, one day to 67 months). At one, two, and three years, the actuarial incidence of sudden death was 17 +/- 3, 25 +/- 4, and 34 +/- 6 per cent, and that of cardiac death was 28 +/- 3, 37 +/- 4, and 50 +/- 6 per cent. Multivariate regression analyses demonstrated that the two strongest predictors of both sudden death and cardiac death were a higher New York Heart Association functional class (P less than 0.0001 for sudden death and P less than 0.0001 for cardiac death) and the failure of any therapy to be identified as potentially effective on the basis of electrophysiologic study (P = 0.0019 and P = 0.0003). The majority of deaths in patients with ventricular tachyarrhythmias were sudden, but the severity of heart failure was the strongest independent predictor of mortality. Response to therapy during electrophysiologic study was also an independent predictor of survival.
This article has been cited by other articles:
von Oppell, U. O., Milne, D., Okreglicki, A., Scott Millar, R. N.
(2002). Surgery for ventricular tachycardia of left ventricular origin: risk factors for success and long-term outcome. Eur. J. Cardiothorac. Surg.
22: 762-770
[Abstract][Full Text]
Schlapfer, J.u., Rapp, F., Kappenberger, L., Fromer, M.
(2002). Electrophysiologically guided amiodarone therapy versus the implantable cardioverter-defibrillator for sustained ventricular tachyarrhythmias after myocardial infarction: Results of long-term follow-up. J Am Coll Cardiol
39: 1813-1819
[Abstract][Full Text]
Balbay, Y., Cosgun, A., Jean-Baptiste, R., Demir, A. D., Tikiz, H., Korkmaz, S., Kutuk, E.
(2001). Effects of Valsalva Maneuver on QT Dispersion in Patients with Ischemic Heart Diseases. ANGIOLOGY
52: 735-741
[Abstract]
Sotoodehnia, N., Zivin, A., Bardy, G. H, Siscovick, D. S
(2001). Reducing mortality from sudden cardiac death in the community: lessons from epidemiology and clinical applications research. Cardiovasc Res
50: 197-209
[Abstract][Full Text]
Raitt, M. H., Renfroe, E. G., Epstein, A. E., McAnulty, J. H., Mounsey, P., Steinberg, J. S., Lancaster, S. E., Jadonath, R. L., Hallstrom, A. P.
(2001). "Stable" Ventricular Tachycardia Is Not a Benign Rhythm : Insights From the Antiarrhythmics Versus Implantable Defibrillators (AVID) Registry. Circulation
103: 244-252
[Abstract][Full Text]
Schilling, R J, Peters, N S, Davies, D W
(1999). Mapping and ablation of ventricular tachycardia with the aid of a non-contact mapping system. Heart
81: 570-575
[Abstract][Full Text]
Ruppel, R., Schluter, C. A., Boczor, S., Meinertz, T., Schluter, M., Kuck, K.-H., Cappato, R.
(1998). Ventricular tachycardia during follow-up in patients resuscitated from ventricular fibrillation: experience from stored electrograms of implantable cardioverter-defibrillators. J Am Coll Cardiol
32: 1724-1730
[Abstract][Full Text]
Marchlinski, F. E.
(1997). Predicting Arrhythmic Death : A Plea for Standardized Reporting Techniques and Data Based on Continuous Electrocardiographic Monitoring. Circulation
96: 1713-1716
[Full Text]
Caruso, A. C., Marcus, F. I., Hahn, E. A., Hartz, V. L., Mason, J. W.
(1997). Predictors of Arrhythmic Death and Cardiac Arrest in the ESVEM Trial. Circulation
96: 1888-1892
[Abstract][Full Text]
Chung, M. K., Pogwizd, S. M., Miller, D. P., Cain, M. E.
(1997). Three-dimensional Mapping of the Initiation of Nonsustained Ventricular Tachycardia in the Human Heart. Circulation
95: 2517-2527
[Abstract][Full Text]
Villacastin, J., Almendral, J., Arenal, A., Albertos, J., Ormaetxe, J., Peinado, R., Bueno, H., Merino, J. L., Pastor, A., Medina, O., Tercedor, L., Jimenez, F., Luis Delcan, J.
(1996). Incidence and Clinical Significance of Multiple Consecutive, Appropriate, High-Energy Discharges in Patients With Implanted Cardioverter-Defibrillators. Circulation
93: 753-762
[Abstract][Full Text]
Reiffel, J. A.
(1996). Data-driven Decisions: The Importance of Clinical Trials in Arrhythmia Management. J CARDIOVASC PHARMACOL THER
1: 79-88
[Abstract]
Sweeney, M. O., Ruskin, J. N., Garan, H., McGovern, B. A., Guy, M. L., Torchiana, D. F., Vlahakes, G. J., Newell, J. B., Semigran, M. J., Dec, G. W.
(1995). Influence of the Implantable Cardioverter/Defibrillator on Sudden Death and Total Mortality in Patients Evaluated for Cardiac Transplantation. Circulation
92: 3273-3281
[Abstract][Full Text]
Arteaga, W. J., Windle, J. R.
(1995). The Quality of Life of Patients With Life-Threatening Arrhythmias. Arch Intern Med
155: 2086-2091
[Abstract]
Grimm, M., Wieselthaler, G., Avanessian, R., Grimm, G., Schmidinger, H., Schreiner, W., Podczeck, A., Wolner, E., Laufer, G.
(1995). THE IMPACT OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS ON MORTALITY AMONG PATIENTS ON THE WAITING LIST FOR HEART TRANSPLANTATION. J. Thorac. Cardiovasc. Surg.
110: 532-539
[Abstract][Full Text]
Venditti, F.J., Mark, E.J.
(1995). Case 16-1995- A 35-year-old man with dilated cardiomyopathy, repeated ventricular tachycardia, and pulmonary lesions. NEJM
332: 1432-1438
[Full Text]
Grimm, M., Grimm, G., Zuckermann, A., Wieselthaler, G., Feuerstein, M., Daneschvar, H., Schmiedinger, H., Schreiner, W., Wolner, E., Laufer, G.
(1995). ICD Therapy in Survivors of Sudden Cardiac Death Awaiting Heart Transplantation. Ann. Thorac. Surg.
59: 916-920
[Abstract][Full Text]
Gettes, L. S.
(1995). ESVEM and the Hazards of Clinical Trials. Circulation
91: 1908-1909
[Full Text]
Reiter, M. J., Mann, D. E., Reiffel, J. E., Hahn, E., Hartz, V.
(1995). Significance and Incidence of Concordance of Drug Efficacy Predictions by Holter Monitoring and Electrophysiological Study in the ESVEM Trial. Circulation
91: 1988-1995
[Abstract][Full Text]
Lee, R., Mitchell, J. D., Garan, H., Ruskin, J. N., McGovern, B. A., Buckley, M. J., Torchiana, D. F., Vlahakes, G. J.
(1994). Operation for recurrent ventricular tachycardiaPredictors of short- and long-term efficacy. J. Thorac. Cardiovasc. Surg.
107: 732-742
[Abstract][Full Text]
Mason, J. W., The Electrophysiologic Study versus Electrocardiog,
(1993). A Comparison of Electrophysiologic Testing with Holter Monitoring to Predict Antiarrhythmic-Drug Efficacy for Ventricular Tachyarrhythmias. NEJM
329: 445-451
[Abstract][Full Text]
Vaitkus, P. T., Capeless, M. A., Stanton, M. S., Gersh, B. I., Hammill, S. C., Steinbeck, G., Andresen, D.
(1993). Electrophysiologically Guided Antiarrhythmic Therapy versus Beta-Blocker Therapy in Patients with Ventricular Tachyarrhythmias. NEJM
328: 357-358
[Full Text]
Bikkina, M., Larson, M. G., Levy, D.
(1992). Prognostic Implications of Asymptomatic Ventricular Arrhythmias: The Framingham Heart Study. ANN INTERN MED
117: 990-996
[Abstract]
Yee, E. S.
(1992). Surgical Outcome for "Normal" Coronary Ventricular Tachyarrhythmias. VASC ENDOVASCULAR SURG
26: 429-433
[Abstract]
Cohen, T. J., Reid, P. R., Mower, M. M., Mirowski, M., Aarons, D., Juanteguy, J., Veltri, E. P.
(1992). The Automatic Implantable Cardioverter-Defibrillator: Long-term Clinical Experience and Outcome at a Hospital Without an Open-Heart Surgery Program. Arch Intern Med
152: 65-69
[Abstract]
Slater, A. D., Singer, I., Stavens, C., Springer, M. J., Gray, L. A. Jr
(1991). Lateral Thoracotomy for the Automatic Implantable Defibrillator. Arch Surg
126: 778-781
[Abstract]
Brooks, R., McGovern, B. A., Garan, H., Ruskin, J. N.
(1991). Current Treatment of Patients Surviving Out-of-Hospital Cardiac Arrest. JAMA
265: 762-768
[Abstract]
Manolis, A. S., Rastegar, H., Estes, N. A. M. III
(1989). Automatic Implantable Cardioverter Defibrillator: Current Status. JAMA
262: 1362-1368
[Abstract]
Tchou, P. J., Kadri, N., Anderson, J., Caceres, J. A., Jazayeri, M., Akhtar, M.
(1988). Automatic Implantable Cardioverter Defibrillators and Survival of Patients with Left Ventricular Dysfunction and Malignant Ventricular Arrhythmias. ANN INTERN MED
109: 529-534
[Abstract]
Borbola, J., Denes, P., Ezri, M. D., Hauser, R. G., Serry, C., Goldin, M. D.
(1988). The Automatic Implantable Cardioverter-Defibrillator: Clinical Experience, Complications, and Follow-up in 25 Patients. Arch Intern Med
148: 70-76
[Abstract]
FOGOROS, R. N., FIEDLER, S. B., ELSON, J. J.
(1987). The Automatic Implantable Cardioverter-Defibrillator in Drug-Refractory Ventricular Tachyarrhythmias. ANN INTERN MED
107: 635-641
[Abstract]
Nalos, P. C., Myers, M. R., Gang, E. S., Peter, T., Mandel, W. J.
(1987). Analytic Reviews: Electrophysiologic Testing in the Intensive Care Unit. J Intensive Care Med
2: 241-259
[Abstract]
MCGOVERN, B., GARAN, H., RUSKIN, J. N.
(1984). Treatment of Ventricular Arrhythmias--Suppression, Survival, and the Problem of Bias. ANN INTERN MED
101: 123-125
[Abstract]
Previous
