Influence of ventricular function and presence or absence of coronary artery disease on results of electrophysiologic testing for asymptomatic nonsustained ventricular tachycardia

Stephen C. Hammill, Jane M. Trusty, Douglas L. Wood, Kent R. Bailey, Pierce J. Vatterott, Michael J. Osborn, David R. Holmes, Bernard J. Gersh

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

One hundred ten patients with asymptomatic non-sustained ventricular tachycardia (VT) were evaluated prospectively to assess the value of electrophysiologic testing. This testing consisted of up to 3 extrastimuli delivered during 3 drive cycle lengths from 2 right ventricular sites. A positive study was defined as monomorphic VT lasting 30 seconds or requiring cardioversion. Patients with a positive study were treated, and serial drug testing was done. An event during follow-up was sustained VT or cardiac arrest. The mean follow-up was 15 months. Of 57 patients with an ejection fraction ≥40%, 6 had a positive electrophysiologic test with 1 event and 51 had a negative test with 1 event. Twenty-eight patients had an ejection fraction <40% and coronary artery disease: 14 had a positive test with 1 event, and 14 had a negative test with 3 events. Twenty-five patients had an ejection fraction <40% and no coronary artery disease: 1 had a positive test with no events, and 24 had a negative test with 8 events. Only ejection fraction and congestive heart failure class were found to be independent predictors of outcome. Patients with an ejection fraction > 40% had low inducibility (11%), had few events (3.5%) and did not require electrophysiologic testing. In patients with an ejection fraction <40% and coronary artery disease, inducibility was high (50%) and a negative study was of no value. Patients with an ejection fraction <40% and no coronary artery disease had low inducibility (4%), had frequent events (33%) and did not benefit from electrophysiologic testing.

Original languageEnglish (US)
Pages (from-to)722-728
Number of pages7
JournalThe American journal of cardiology
Volume65
Issue number11
DOIs
StatePublished - Mar 15 1990

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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