Assessment of electrophysiologic testing

New York, June 30, 2000 (Praxis Press) Mortality rates from coronary artery disease (CAD), abnormal ventricular function and unsustained ventricular tachycardia are high. In patients with a history of myocardial infarction, cardiac arrest is often the result of reentrant ventricular tachycardia or fibrillation. Studies have not clearly assessed the prognostic value of electrophysiologic testing for these cases. In the Multicenter Unsustained Tachycardia Trial, Buxton et al performed electrophys

June 30, 2000

New York, June 30, 2000 (Praxis Press) Mortality rates from coronary artery disease (CAD), abnormal ventricular function and unsustained ventricular tachycardia are high. In patients with a history of myocardial infarction, cardiac arrest is often the result of reentrant ventricular tachycardia or fibrillation. Studies have not clearly assessed the prognostic value of electrophysiologic testing for these cases. In the Multicenter Unsustained Tachycardia Trial, Buxton et al performed electrophysiologic testing to group of such patients and randomly assigned patients with inducible tachyarrhythmias to either antiarrhythmic therapy guided by electrophysiologic testing or no therapy at all (see paper). The findings show that induction of sustained ventricular tachyarrhythmias by programmed stimulation identifies patients at greater risk of death from arrhythmia. In this study, the procedure had a negative predictive value of 88 percent for death due to arrhythmia within two years for patients without inducible arrhythmia. The value of this prognosis may diminish with time however, because of the progression of coronary disease and the ensuing formation of new circuits.

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