Programmed ventricular stimulation in patients with idiopathic dilated cardiomyopathy and syncope receiving implantable cardioverter-defibrillators: A case series and a systematic review of the literature

Emmanouil S. Brilakis, Paul Andrew Friedman, Themos N. Maounis, Stylianos G. Rokas, Win Kuang Shen, Stamatios F. Stamatelopoulos, Dennis V. Cokkinos

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: The role of programmed ventricular stimulation (PVS) in patients with idiopathic dilated cardiomyopathy (DCM) and syncope receiving implantable cardioverter-defibrillators (ICD) remains controversial. Methods and results: Between 1994 and July 2002, 20 patients with DCM and syncope underwent PVS and ICD implantation at the Onassis Cardiac Surgery Center or the Alexandra General Hospital. At PVS 10 patients had inducible sustained monomorphic ventricular tachycardia (SMVT), 3 patients had inducible sustained polymorphic ventricular tachycardia or ventricular fibrillation, and 7 patients had no inducible arrhythmia. The latter 7 patients received an ICD because of clinical occurrence of ventricular tachycardia (n=5) or fibrillation (n=2). Mean age was 55±14 years; 80% were men. During a mean follow-up of 2.8±2.3 years, 12 of the 20 patients received an appropriate shock. The incidence of appropriate shocks at 1 and 3 years was 69% and 84% in the inducible SMVT group, and 56% and 67% in the group without inducible SMVT (p=0.93, log rank test). Overall survival was similar in both groups (p=0.53). In a systematic review of the published literature 18 of 75 (24%) patients with DCM, syncope and a negative PVS had an appropriate ICD shock after a mean follow-up of 27 months. Conclusion: PVS has a limited role in risk stratification of patients with DCM and syncope.

Original languageEnglish (US)
Pages (from-to)395-401
Number of pages7
JournalInternational Journal of Cardiology
Volume98
Issue number3
DOIs
StatePublished - Feb 28 2005

Fingerprint

Implantable Defibrillators
Dilated Cardiomyopathy
Syncope
Ventricular Tachycardia
Shock
Ventricular Fibrillation
General Hospitals
Thoracic Surgery
Cardiac Arrhythmias
Survival
Incidence

Keywords

  • Cardiomyopathy
  • Congestive heart failure
  • Defibrillators
  • Implantable
  • Syncope

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Programmed ventricular stimulation in patients with idiopathic dilated cardiomyopathy and syncope receiving implantable cardioverter-defibrillators : A case series and a systematic review of the literature. / Brilakis, Emmanouil S.; Friedman, Paul Andrew; Maounis, Themos N.; Rokas, Stylianos G.; Shen, Win Kuang; Stamatelopoulos, Stamatios F.; Cokkinos, Dennis V.

In: International Journal of Cardiology, Vol. 98, No. 3, 28.02.2005, p. 395-401.

Research output: Contribution to journalArticle

Brilakis, Emmanouil S. ; Friedman, Paul Andrew ; Maounis, Themos N. ; Rokas, Stylianos G. ; Shen, Win Kuang ; Stamatelopoulos, Stamatios F. ; Cokkinos, Dennis V. / Programmed ventricular stimulation in patients with idiopathic dilated cardiomyopathy and syncope receiving implantable cardioverter-defibrillators : A case series and a systematic review of the literature. In: International Journal of Cardiology. 2005 ; Vol. 98, No. 3. pp. 395-401.
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AU - Friedman, Paul Andrew

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AB - Background: The role of programmed ventricular stimulation (PVS) in patients with idiopathic dilated cardiomyopathy (DCM) and syncope receiving implantable cardioverter-defibrillators (ICD) remains controversial. Methods and results: Between 1994 and July 2002, 20 patients with DCM and syncope underwent PVS and ICD implantation at the Onassis Cardiac Surgery Center or the Alexandra General Hospital. At PVS 10 patients had inducible sustained monomorphic ventricular tachycardia (SMVT), 3 patients had inducible sustained polymorphic ventricular tachycardia or ventricular fibrillation, and 7 patients had no inducible arrhythmia. The latter 7 patients received an ICD because of clinical occurrence of ventricular tachycardia (n=5) or fibrillation (n=2). Mean age was 55±14 years; 80% were men. During a mean follow-up of 2.8±2.3 years, 12 of the 20 patients received an appropriate shock. The incidence of appropriate shocks at 1 and 3 years was 69% and 84% in the inducible SMVT group, and 56% and 67% in the group without inducible SMVT (p=0.93, log rank test). Overall survival was similar in both groups (p=0.53). In a systematic review of the published literature 18 of 75 (24%) patients with DCM, syncope and a negative PVS had an appropriate ICD shock after a mean follow-up of 27 months. Conclusion: PVS has a limited role in risk stratification of patients with DCM and syncope.

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