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, M. M. 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 - Dec 1 1989

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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