This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Buxton, A. E. Articles by Josephson, M. E. Search for Related Content PubMed PubMed Citation Articles by Buxton, A. E. Articles by Josephson, M. E.

Circulation, Vol 75, 1178-1185, Copyright © 1987 by American Heart Association

ARTICLES

Nonsustained ventricular tachycardia in patients with coronary artery disease: role of electrophysiologic study

AE Buxton, FE Marchlinski, BT Flores, JM Miller, JU Doherty and ME Josephson

Sixty-two consecutive patients with chronic coronary artery disease referred for evaluation of nonsustained ventricular tachycardia (VT) underwent electrophysiologic studies. Sustained VT was induced by one to three ventricular extrastimuli in 28 patients (45%). Therapy was guided by the results of electrophysiologic testing in 44 patients: 19 patients without inducible sustained VT received no antiarrhythmic therapy, and 25 patients with inducible sustained or symptomatic nonsustained VT received therapy guided by the results of electrophysiologic studies. The results of electrophysiologic studies were ignored by physicians for a second group of 18 patients: four had inducible sustained VT but received no antiarrhythmic therapy, and 14 had inducible sustained or nonsustained VT and received antiarrhythmic therapy not guided by results of electrophysiologic testing. After a mean follow-up period of 28 months, 11 patients had died suddenly. Seven of the 11 patients who died suddenly had inducible sustained VT. Three of 44 patients in the group receiving therapy guided by electrophysiologic studies died suddenly versus eight of 18 in the group receiving therapy not guided by electrophysiologic studies (p = .001). Only one of 19 patients without inducible sustained VT who were not treated experienced sudden death. Two of four patients with inducible sustained VT who did not receive antiarrhythmic therapy died suddenly. Multivariate analysis of the relationship of induced arrhythmias, left ventricular ejection fraction, site of myocardial infarction, history of syncope, or type of antiarrhythmic therapy to outcome revealed a greater than twofold increased risk for sudden cardiac death in patients whose therapy was not guided by results of electrophysiologic study.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				R. J. Myerburg, V. Reddy, and A. Castellanos Indications for implantable cardioverter-defibrillators based on evidence and judgment. J. Am. Coll. Cardiol., August 25, 2009; 54(9): 747 - 763. [Abstract] [Full Text] [PDF]

				S. Rolf, W. Haverkamp, M. Borggrefe, G. Breithardt, and D. Bocker Induction of ventricular fibrillation rather than ventricular tachycardia predicts tachyarrhythmia recurrences in patients with idiopathic dilated cardiomyopathy and implantable cardioverter defibrillator for secondary prophylaxis Europace, March 1, 2009; 11(3): 289 - 296. [Abstract] [Full Text] [PDF]

				R. J. Myerburg Implantable Cardioverter-Defibrillators after Myocardial Infarction N. Engl. J. Med., November 20, 2008; 359(21): 2245 - 2253. [Full Text] [PDF]

				G. M. De Ferrari, R. Rordorf, F. Frattini, B. Petracci, P. De Filippo, and M. Landolina Predictive value of programmed ventricular stimulation in patients with ischaemic cardiomyopathy: implications for the selection of candidates for an implantable defibrillator Europace, December 1, 2007; 9(12): 1151 - 1157. [Abstract] [Full Text] [PDF]

				K. Nanthakumar, I. M. Billingsley, S. Masse, P. Dorian, D. Cameron, V. S. Chauhan, E. Downar, and E. Sevaptsidis Cardiac Electrophysiological Consequences of Neuromuscular Incapacitating Device Discharges J. Am. Coll. Cardiol., August 15, 2006; 48(4): 798 - 804. [Abstract] [Full Text] [PDF]

				D. S. Lee, L. D. Green, P. P. Liu, P. Dorian, D. M. Newman, F. C. Grant, J. V. Tu, and D. A. Alter Effectiveness of implantable defibrillators for preventing arrhythmic events and death: A Meta-Analysis J. Am. Coll. Cardiol., May 7, 2003; 41(9): 1573 - 1582. [Abstract] [Full Text] [PDF]

				S. G. Priori, E. Aliot, C. Blomstrom-Lundqvist, L. Bossaert, G. Breithardt, P. Brugada, J. A. Camm, R. Cappato, S. M. Cobbe, C. Di Mario, et al. TASK FORCE ON SUDDEN CARDIAC DEATH, EUROPEAN SOCIETY OF CARDIOLOGY: Summary of Recommendations Europace, January 1, 2002; 4(1): 3 - 18. [Abstract] [PDF]

				L. A. Pires, M. H. Lehmann, A. E. Buxton, G. E. Hafley, K. L. Lee, and the Multicenter Unsustained Tachycardia Trial Inve Differences in inducibility and prognosis of in-hospital versus out-of-hospital identified nonsustained ventricular tachycardia in patients with coronary artery disease: clinical and trial design implications J. Am. Coll. Cardiol., October 1, 2001; 38(4): 1156 - 1162. [Abstract] [Full Text] [PDF]

				S.G. Priori, E. Aliot, C. Blomstrom-Lundqvist, L. Bossaert, G. Breithardt, P. Brugada, A.J. Camm, R. Cappato, S.M. Cobbe, C. Di Mario, et al. Task Force on Sudden Cardiac Death of the European Society of Cardiology Eur. Heart J., August 2, 2001; 22(16): 1374 - 1450. [PDF]

				A. E. Buxton, K. L. Lee, L. DiCarlo, M. R. Gold, G. S. Greer, E. N. Prystowsky, M. F. O'Toole, A. Tang, J. D. Fisher, J. Coromilas, et al. Electrophysiologic Testing to Identify Patients with Coronary Artery Disease Who Are at Risk for Sudden Death N. Engl. J. Med., June 29, 2000; 342(26): 1937 - 1945. [Abstract] [Full Text] [PDF]

				A. E. Buxton, K. L. Lee, J. D. Fisher, M. E. Josephson, E. N. Prystowsky, G. Hafley, and The Multicenter Unsustained Tachycardia Trial Inve A Randomized Study of the Prevention of Sudden Death in Patients with Coronary Artery Disease N. Engl. J. Med., December 16, 1999; 341(25): 1882 - 1890. [Abstract] [Full Text] [PDF]

				P. J. Welch, R. L. Page, and M. H. Hamdan Management of ventricular arrhythmias: A trial-based approach J. Am. Coll. Cardiol., September 1, 1999; 34(3): 621 - 630. [Abstract] [Full Text] [PDF]

				J. J. Goldberger Treatment and Prevention of Sudden Cardiac Death: Effect of Recent Clinical Trials Arch Intern Med, June 28, 1999; 159(12): 1281 - 1287. [Abstract] [Full Text] [PDF]

				A. E. Buxton, G. E. Hafley, M. H. Lehmann, M. Gold, M. O'Toole, A. Tang, J. Coromilas, B. Hook, N. J. Stamato, and K. L. Lee Prediction of Sustained Ventricular Tachycardia Inducible by Programmed Stimulation in Patients With Coronary Artery Disease : Utility of Clinical Variables Circulation, April 13, 1999; 99(14): 1843 - 1850. [Abstract] [Full Text] [PDF]