Electrophysiologic Testing to Identify Patients with Coronary Artery Disease Who Are at Risk for Sudden Death

doi:10.1056/NEJM200006293422602

Volume 342:1937-1945		June 29, 2000		Number 26

Electrophysiologic Testing to Identify Patients with Coronary Artery Disease Who Are at Risk for Sudden Death

Alfred E. Buxton, M.D., Kerry L. Lee, Ph.D., Lorenzo DiCarlo, M.D., Michael R. Gold, M.D., G. Stephen Greer, M.D., Eric N. Prystowsky, M.D., Michael F. O'Toole, M.D., Anthony Tang, M.D., John D. Fisher, M.D., James Coromilas, M.D., Mario Talajic, M.D., Gail Hafley, M.S., for The Multicenter Unsustained Tachycardia Trial Investigators

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ABSTRACT

Background The mortality rate among patients with coronary arterydisease, abnormal ventricular function, and unsustained ventriculartachycardia is high. The usefulness of electrophysiologic testingfor risk stratification in these patients is unclear.

Methods We performed electrophysiologic testing in patientswho had coronary artery disease, a left ventricular ejectionfraction of 40 percent or less, and asymptomatic, unsustainedventricular tachycardia. Patients in whom sustained ventriculartachyarrhythmias could be induced were randomly assigned toreceive either antiarrhythmic therapy guided by electrophysiologictesting or no antiarrhythmic therapy. The primary end pointwas cardiac arrest or death from arrhythmia. Patients withoutinducible tachyarrhythmias were followed in a registry. We comparedthe outcomes of 1397 patients in the registry with those of353 patients with inducible tachyarrhythmias who were randomlyassigned to receive no antiarrhythmic therapy in order to assessthe prognostic value of electrophysiologic testing.

Results Patients were followed for a median of 39 months. Ina Kaplan–Meier analysis, two-year and five-year ratesof cardiac arrest or death due to arrhythmia were 12 and 24percent, respectively, among the patients in the registry, ascompared with 18 and 32 percent among the patients with inducibletachyarrhythmias who were assigned to no antiarrhythmic therapy(adjusted P<0.001). Overall mortality after five years was48 percent among the patients with inducible tachyarrhythmias,as compared with 44 percent among the patients in the registry(adjusted P= 0.005). Deaths among patients without inducibletachyarrhythmias were less likely to be classified as due toarrhythmia than those among patients with inducible tachyarrhythmias(45 and 54 percent, respectively; P=0.06).

Conclusions Patients with coronary artery disease, left ventriculardysfunction, and asymptomatic, unsustained ventricular tachycardiain whom sustained ventricular tachyarrhythmias cannot be inducedhave a significantly lower risk of sudden death or cardiac arrestand lower overall mortality than similar patients with induciblesustained tachyarrhythmias.

Source Information

From Brown University School of Medicine and Rhode Island Hospital, Providence (A.E.B.); Duke University Clinical Research Institute, Durham, N.C. (K.L.L., G.H.); Michigan Heart, Ann Arbor (L.D.); the University of Maryland School of Medicine, Baltimore (M.R.G.); Arkansas Cardiology Clinic, Little Rock (G.S.G.); Northside Cardiology, Indianapolis (E.N.P.); Midwest Heart Research Foundation, Lombard, Ill. (M.F.O.); the University of Ottawa Heart Institute, Ottawa, Ont., Canada (A.T.); Montefiore Medical Center and Albert Einstein School of Medicine, Bronx, N.Y. (J.D.F.); Columbia University School of Medicine, New York (J.C.); and the Montreal Heart Institute, Montreal (M.T.).

Address reprint requests to Dr. Buxton at the Division of Cardiology, Rhode Island Hospital, 2 Dudley St., Suite 360, Providence, RI 02905.

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Electrophysiologic Testing to Identify Patients at Risk for Sudden Death
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N Engl J Med 2000; 343:1813-1814, Dec 14, 2000. Correspondence

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Kusumoto, F. M., Goldschlager, N. (2002). Device Therapy for Cardiac Arrhythmias. JAMA 287: 1848-1852 [Full Text]
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Sanders, G. D., Hlatky, M. A., Every, N. R., McDonald, K. M., Heidenreich, P. A., Parsons, L. S., Owens, D. K. (2001). Potential Cost-Effectiveness of Prophylactic Use of the Implantable Cardioverter Defibrillator or Amiodarone after Myocardial Infarction. ANN INTERN MED 135: 870-883 [Abstract] [Full Text]
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