Follow-up of patients with ventricular tachyarrhythmia treated with the automatic implantable cardioverter defibrillator: Programmed electrical stimulation results do not predict clinical outcome

E. P. Veltri, Morton Maimon Mower, M. Mirowski, J. Juanteguy, L. Watkins, J. H. Levine, T. Guarnieri, P. R. Reid, L. S C Griffith

Research output: Contribution to journalArticle

Abstract

During a 6-year cumulative experience, 163 patients with drug-refractory ventricular tachycardia/fibrillation (VT/VF) underwent automatic implantable defibrillator (AID) and/or automatic implantable cardioverter defibrillator (AICD) implantation at our institutions. Baseline preimplantation programmed electrical stimulation was performed in 160 patients revealing induction of sustained arrhythmias in 115 patients (71%), nonsustained arrhythmia in 20 patients (13%), and noninducible arrhythmia in 25 patients (16%). Operative mortality was 4.9%. At 22 -+ 15 (mean -+ standard deviation) months follow-up 77 patients (50%) had experienced at least one appropriate AID/AICD discharge. The acturial incidence of sudden cardiac death (VT/VF death within 1 hour of symptoms or during sleep) in the AICD population was 1.8% and 4.1% at 1 and 2 years, respectively. Excluding patients with operative death and those responding to concomitant subenocardial resection (no longer inducible arrhythmias), the incidence of clinical arrhythmic event (AICD discharge and/or VT/VF death) in patients with sustained, nonsustained, and noninducible arrhythmias were not significantly different. We conclude that the AICD appears to reduce the expected incidence of sudden cardiac death in patients with drug-refractory VT/VF and that selection for AICD therapy should not be based on results of baseline programmed electrical stimulation alone.

Original languageEnglish (US)
Pages (from-to)467-476
Number of pages10
JournalJournal of Electrophysiology
Volume3
Issue number6
StatePublished - 1989

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Implantable Defibrillators
Tachycardia
Electric Stimulation
Cardiac Arrhythmias
Sudden Cardiac Death
Incidence
Ventricular Fibrillation
Ventricular Tachycardia
Pharmaceutical Preparations
Sleep
Mortality

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Follow-up of patients with ventricular tachyarrhythmia treated with the automatic implantable cardioverter defibrillator : Programmed electrical stimulation results do not predict clinical outcome. / Veltri, E. P.; Mower, Morton Maimon; Mirowski, M.; Juanteguy, J.; Watkins, L.; Levine, J. H.; Guarnieri, T.; Reid, P. R.; Griffith, L. S C.

In: Journal of Electrophysiology, Vol. 3, No. 6, 1989, p. 467-476.

Research output: Contribution to journalArticle

Veltri, E. P. ; Mower, Morton Maimon ; Mirowski, M. ; Juanteguy, J. ; Watkins, L. ; Levine, J. H. ; Guarnieri, T. ; Reid, P. R. ; Griffith, L. S C. / Follow-up of patients with ventricular tachyarrhythmia treated with the automatic implantable cardioverter defibrillator : Programmed electrical stimulation results do not predict clinical outcome. In: Journal of Electrophysiology. 1989 ; Vol. 3, No. 6. pp. 467-476.
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