This Article Full Text 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 Marchlinski, F. E. Search for Related Content PubMed PubMed Citation Articles by Marchlinski, F. E.

(Circulation. 1997;96:1713-1716.)
© 1997 American Heart Association, Inc.

Articles

Predicting Arrhythmic Death

A Plea for Standardized Reporting Techniques and Data Based on Continuous Electrocardiographic Monitoring

Francis E. Marchlinski, MD

From the Electrophysiology Section, Allegheny University Hospitals, Allegheny University of the Health Sciences, The Sidney Kimmel Foundation, and The Philadelphia Heart Institute, Philadelphia, Pa.

Correspondence to Francis E. Marchlinski, MD, Electrophysiology Section, Allegheny University Hospitals, Broad and Vine, Mail Stop 471, Philadelphia, PA 19102-1192.

Key Words: Editorials • arrhythmia • mortality • electrophysiology • sudden death

	Introduction

 
Large, multicenter studies aimed at defining optimum treatment strategies for patients with documented ventricular arrhythmias and for patients at high risk of arrhythmia events have been completed and continue to be established.^{1 2 3 4} After finding the answer to the proposed study questions, the participating investigators recognize that they have a wealth of data collected prospectively. Wisely, they struggle to analyze the data to address important clinical questions related to their study population.^{5 6 7 8 9} Frequently, they try to identify clinical variables that might predict an outcome event defined by the study.^{7 9}

In this issue of Circulation, Caruso and colleagues¹⁰ perform such an analysis in patients who enrolled in the ESVEM trial. The authors demonstrate that left ventricular ejection fraction was the only independent predictor of arrhythmic death or cardiac arrest in the ESVEM patient population. The authors' data add to a long list of publications that have identified left ventricular ejection fraction as an important predictor of arrhythmia events, arrhythmic death, or cardiac arrest and overall mortality rate in patients who have a history of documented arrhythmia episodes.^{11 12 13 14 15 16 17 18 19} The authors also suggest that their data may help to identify a patient group with a very low risk for recurrent, life-threatening arrhythmic events. They indicate that only 1 of 19 patients who presented with a cardiac arrest and had a left ventricular ejection fraction >40% developed a life-threatening arrhythmic event during follow-up. They suggest that these data may be important in deciding whether to advise the patient to have implantable defibrillator therapy. A . . . [Full Text of this Article]

This article has been cited by other articles:

				A. Pacifico, L. L. Ferlic, F.e. R. Cedillo-Salazar, N. Nasir Jr, T. K. Doyle, and P. D. Henry Shocks as predictors of survival in patients with implantable cardioverter-defibrillators J. Am. Coll. Cardiol., July 1, 1999; 34(1): 204 - 210. [Abstract] [Full Text] [PDF]