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 language||English (US)|
|Number of pages||10|
|Journal||Journal of Electrophysiology|
|State||Published - Dec 1 1989|
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine