The Value of Electrophysiologic Testing in Patients Resuscitated From Documented Ventricular Fibrillation
Identifieur interne : 004203 ( Main/Exploration ); précédent : 004202; suivant : 004204The Value of Electrophysiologic Testing in Patients Resuscitated From Documented Ventricular Fibrillation
Auteurs : Huagui G. Li [Canada] ; Ranjan K. Thakur [Canada] ; Raymond Yee [Canada] ; George J. Klein [Canada]Source :
- Journal of Cardiovascular Electrophysiology [ 1045-3873 ] ; 1994-10.
English descriptors
Abstract
EP Study and Ventricular Fibrillation. Introduction: Electrophysiologic testing is performed in patients resuscitated from ventricular fibrillation (VF) on the assumption that sustained monomorphic ventricular tachycardia (VT) may be a precursor to VF, with the former amenable to assessment by serial drug testing. Methods and Results: We assessed the usefulness of this strategy by analyzing clinical and electrophysiologic data of 42 survivors (29 men and 13 women; mean age 54 ± 14 years) of VF without a reversible cause. All patients had VF documented on ECG and required defibrillation. Underlying heart diseases included coronary disease in 28, dilated cardiomyopathy in 3, arrhythmogenic right ventricular dysplasia in 1, and no apparent structural heart disease in 10 patients. Only 2 (4.7%) patients had a prior history of documented VT. The electrophysiologic study was performed 7 to 30 days after VF. Programmed stimulation at the right ventricular apex using at least two drive cycle lengths and up to three extrastimuli induced sustained monomorphic VT in 4 (9.5%), sustained polymorphic VT in 3 (7.1%), nonsustained monomorphic VT in 1 (2.3%), nonsustained polymorphic VT in 5 (11.9%), and VF in 13 (30.9%) patients. Two patients with documented prior VT and coronary disease had sustained VT induced during the electrophysiologic study. On the other hand, sustained monomorphic VT was induced in 53 of the 59 (90%) patients (45 men and 14 women; mean age 57 ± 16 years) with clinically documented VT concurrently studied using the same stimulation protocol. Conclusion: We conclude that reproducible induction of sustained monomorphic VT in survivors of documented VF is uncommon. It may be more cost effective to proceed directly to treatment with implantable cardioverter defibrillators in these patients.
Url:
DOI: 10.1111/j.1540-8167.1994.tb01118.x
Affiliations:
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">The Value of Electrophysiologic Testing in Patients Resuscitated From Documented Ventricular Fibrillation</title><author><name sortKey="Li, Huagui G" sort="Li, Huagui G" uniqKey="Li H" first="Huagui G." last="Li">Huagui G. Li</name></author><author><name sortKey="Thakur, Ranjan K" sort="Thakur, Ranjan K" uniqKey="Thakur R" first="Ranjan K." last="Thakur">Ranjan K. Thakur</name></author><author><name sortKey="Yee, Raymond" sort="Yee, Raymond" uniqKey="Yee R" first="Raymond" last="Yee">Raymond Yee</name></author><author><name sortKey="Klein, George J" sort="Klein, George J" uniqKey="Klein G" first="George J." last="Klein">George J. Klein</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:DD31CECEEE392C78AA9736402A374C54C6E9071B</idno><date when="1994" year="1994">1994</date><idno type="doi">10.1111/j.1540-8167.1994.tb01118.x</idno><idno type="url">https://api-v5.istex.fr/document/DD31CECEEE392C78AA9736402A374C54C6E9071B/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001191</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001191</idno><idno type="wicri:Area/Istex/Curation">001191</idno><idno type="wicri:Area/Istex/Checkpoint">001B30</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">001B30</idno><idno type="wicri:doubleKey">1045-3873:1994:Li H:the:value:of</idno><idno type="wicri:Area/Main/Merge">004960</idno><idno type="wicri:Area/Main/Curation">004203</idno><idno type="wicri:Area/Main/Exploration">004203</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">The Value of Electrophysiologic Testing in Patients Resuscitated From Documented Ventricular Fibrillation</title><author><name sortKey="Li, Huagui G" sort="Li, Huagui G" uniqKey="Li H" first="Huagui G." last="Li">Huagui G. Li</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Thakur, Ranjan K" sort="Thakur, Ranjan K" uniqKey="Thakur R" first="Ranjan K." last="Thakur">Ranjan K. Thakur</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Yee, Raymond" sort="Yee, Raymond" uniqKey="Yee R" first="Raymond" last="Yee">Raymond Yee</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Klein, George J" sort="Klein, George J" uniqKey="Klein G" first="George J." last="Klein">George J. Klein</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Cardiovascular Electrophysiology</title><idno type="ISSN">1045-3873</idno><idno type="eISSN">1540-8167</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1994-10">1994-10</date><biblScope unit="volume">5</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="805">805</biblScope><biblScope unit="page" to="809">809</biblScope></imprint><idno type="ISSN">1045-3873</idno></series><idno type="istex">DD31CECEEE392C78AA9736402A374C54C6E9071B</idno><idno type="DOI">10.1111/j.1540-8167.1994.tb01118.x</idno><idno type="ArticleID">JCE805</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1045-3873</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>electrophysiologic testing</term><term>ventricular fibrillation</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">EP Study and Ventricular Fibrillation. Introduction: Electrophysiologic testing is performed in patients resuscitated from ventricular fibrillation (VF) on the assumption that sustained monomorphic ventricular tachycardia (VT) may be a precursor to VF, with the former amenable to assessment by serial drug testing. Methods and Results: We assessed the usefulness of this strategy by analyzing clinical and electrophysiologic data of 42 survivors (29 men and 13 women; mean age 54 ± 14 years) of VF without a reversible cause. All patients had VF documented on ECG and required defibrillation. Underlying heart diseases included coronary disease in 28, dilated cardiomyopathy in 3, arrhythmogenic right ventricular dysplasia in 1, and no apparent structural heart disease in 10 patients. Only 2 (4.7%) patients had a prior history of documented VT. The electrophysiologic study was performed 7 to 30 days after VF. Programmed stimulation at the right ventricular apex using at least two drive cycle lengths and up to three extrastimuli induced sustained monomorphic VT in 4 (9.5%), sustained polymorphic VT in 3 (7.1%), nonsustained monomorphic VT in 1 (2.3%), nonsustained polymorphic VT in 5 (11.9%), and VF in 13 (30.9%) patients. Two patients with documented prior VT and coronary disease had sustained VT induced during the electrophysiologic study. On the other hand, sustained monomorphic VT was induced in 53 of the 59 (90%) patients (45 men and 14 women; mean age 57 ± 16 years) with clinically documented VT concurrently studied using the same stimulation protocol. Conclusion: We conclude that reproducible induction of sustained monomorphic VT in survivors of documented VF is uncommon. It may be more cost effective to proceed directly to treatment with implantable cardioverter defibrillators in these patients.</div></front></TEI><affiliations><list><country><li>Canada</li></country></list><tree><country name="Canada"><noRegion><name sortKey="Li, Huagui G" sort="Li, Huagui G" uniqKey="Li H" first="Huagui G." last="Li">Huagui G. Li</name></noRegion><name sortKey="Klein, George J" sort="Klein, George J" uniqKey="Klein G" first="George J." last="Klein">George J. Klein</name><name sortKey="Thakur, Ranjan K" sort="Thakur, Ranjan K" uniqKey="Thakur R" first="Ranjan K." last="Thakur">Ranjan K. Thakur</name><name sortKey="Yee, Raymond" sort="Yee, Raymond" uniqKey="Yee R" first="Raymond" last="Yee">Raymond Yee</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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