Evaluation and treatment of nonsustained ventricular tachycardia

Current Opinion in Cardiology

Volumn 11, Issue 1, 1996, Pages 23-31

  Wilber, David J ^a  

^a UNIVERSITY OF CHICAGO   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AMIODARONE; ANTIARRHYTHMIC AGENT; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR;

AMBULATORY MONITORING; CLINICAL TRIAL; CONGESTIVE HEART FAILURE; CONTROLLED CLINICAL TRIAL; HEART DILATATION; HEART VENTRICLE TACHYCARDIA; HUMAN; HYPERTROPHIC CARDIOMYOPATHY; LONG QT SYNDROME; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; REVIEW; SUDDEN DEATH;

AMIODARONE; ANTI-ARRHYTHMIA AGENTS; CARDIOMEGALY; CARDIOMYOPATHY, DILATED; ELECTROCARDIOGRAPHY; HEART FAILURE, CONGESTIVE; HUMANS; MYOCARDIAL INFARCTION; PROGNOSIS; RANDOMIZED CONTROLLED TRIALS; RISK FACTORS; TACHYCARDIA, VENTRICULAR; VASODILATOR AGENTS;

EID: 0029965859     PISSN: 02684705     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001573-199601000-00005     Document Type: Review

References (28)

1. Wilber DJ, Kopp O, Olshansky B, Kall JG, Kinder K: Nonsustained ventricular tachycardia and other high-risk predictors following myocardial infarction: Implications for prophylactic automatic implantable cardioverter-defibrillator use. Prog Cardiovasc Dis 1993, 36:179-194.
2. Wilber DJ, Olshansky B, Moran JF, Scanlon PJ: Electrophysiologic testing and nonsustained ventricular tachycardia: use and limitations in patients with coronary artery disease and impaired ventricular function. Circulation 1990, 82:350-358.
3. Kinder C, Tamburro P, Kopp D, Kall J Olshansky B, Wilber D: The clinical significance of nonsustained ventricular tachycardia: current perspectives. PACE Pacing Clin Electrophysiol 1994, 17:637-664.
4. Hernandez M, Taylor J, Marinchak R, Rials S, Rubin A, Kowey P: Outcome of patients with NSVT and severely impaired ventricular function who have negative electrophysiologic studies. Am Heart J 1995, 129:492-496. In contrast to previous reports of the outcome of programmed stimulation in patients with NSVT and remote myocardial infarction, this study found a high incidence of sudden death in patients without inducible SMVT.
5. Kadish A, Schmaltz S, Calkins H, Morady F: Management of nonsustained ventricular tachycardia guided by electrophysiological testing. PACE Pacing Clin Electrophysiol 1993, 16:1037-1050.
6. Richards DA, Byth K, Ross DL, Uther JB: What is the best predictor of spontaneous ventricular tachycardia and sudden death after myocardial infarction? Circulation 1991, 83:756-763.
7. The Cardiac Arrhythmia Suppression Trial (CAST) Investigators: Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 1989, 32:321:406-412.
8. The Cardiac Arrhythmia Suppression Trial II Investigators: Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. N Engl J Med 1992, 327:227-233.
9. Anderson JL, Platia EV, Hallstrom A, Henthorne RW, Buckingham TA, Carlson MD, Carson PE: Interaction of baseline characteristics with the hazard of encainide, flecainide, and moricizine therapy in patient with myocardial infarction. Circulation 1994, 909:2843-2852. Post hoc subgroup analysis of CAST identified three baseline characteristics that were associated with a higher risk of death during antiarrhythmic drug therapy: non-Q wave infarction, PVC frequency of 50 or more per hour, and heart rate of 74 bpm or higher.
10. Goldstein S, Brooks MM, Ledingham R, Kennedy HL, Epstein AE, Pawitan Y, Bigger T: Association between ease of suppression of ventricular arrhythmia and survival. Circulation 1995, 91:79-83. Another post hoc analysis of CAST demonstrated that ease of suppression of premature ventricular beats identifies a subgroup of patients following myocardial infarction who have a low risk of arrhythmic death.
11. Singh SN, Retcher RD, Fisher SG, Singh BN, Lewis HD, Deedwania PC, Massie BM, Colling C, Lazzeri D: Amiodarone In patients with congestive heart failure and ventricular arrhythmia. N Engl J Med 1995, 333:77-82. This important placebo-controlled study examined the effect of amiodarone on survival in patients with congestive heart failure, ejection fraction of 40% or lower, and asymptomatic ventricular arrhythmias (including NSVT). Amiodarone had no effect on survival during a mean follow-up of 45 months.
12. Doval HC, Nul DR, Grancelli HO, Perrone SV, Bortman GR, Curiel R: Randomized trial of low-dose amiodarone in severe heart failure. Lancet 1994, 344:493-498. Another major randomized study of prophylactic amiodarone therapy in patients with severe heart failure. The trial was stopped prematurely after a mean 13-month follow-up due to excess mortality in control patients. Amiodarone was associated with a 28% reduction in total mortality.
13. Camm AJ, Julian D, Janse G, Munoz A, Schwartz P, Simon P, Frangin G: The European Myocardial Infarct Amiodarone Trial (EMIAT). Am J Cardiol 1993, 72 (suppl):95F-98F.
14. Pratt CM, Gardner M, Pepine C, Kohn R, Young JB, Greenberg B, Capone R, Kostis J, Henzlova M, Gosselin G, et al.: Lack of long-term ventricular arrhythmia reduction by enalapril In heart failure. Am J Cardiol 1995, 75:1244-1249. Analysis of the SOLVD (N Engl J Med 1992, 327:685-691) data revealed that enalapril had no influence on the frequency of NSVT relative to placebo, consistent with the overall study finding of no effect on sudden death or arrhythmic events (in contrast to a reduction in deaths due to heart failure).
15. The Studies of Left Ventricular Dysfunction Investigators: Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fraction. N Engl J Med 1992, 327:685-691.
16. The Cooperative North Scandinavian Enalapril Survival Study Trial Study Group: Effects of enalapril on mortality in severe congestive heart failure: results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 1987, 316:1429-1435.
17. Pfeffer MA, Braunwald E, Moye LA, Basta L, Brown EJ, Cuddy TE, et al.: Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 1992, 327:669-677.
18. Francis GS, Cohn JN, Johnson G, Rector TS, Goldman S, Simon A: Enalapril decreases prevalence of ventricular tachycardia in patients with chronic congestive heart failure. Circulation 1993, 87 (suppl): V-140-V-148.
19. Leenhardt A, Lucet V, Denjoy I, Grau F, Ngoc DD, Coumel P: Catecholaminergic polymorphic ventricular tachycardia in children. Circulation 1995, 91:1512-1519. This paper is the largest series published of a previously ill-defined syndrome presenting with syncope in children or adolescents with structurally normal hearts. The syndrome is characterized by stress-or emotion-induced episodes of polymorphic NSVT in the presence of normal QT intervals, often with a distinctive bidirectional QRS morphology. Although β-blockade is usually effective, untreated cases have a high risk of sudden death.
20. Eisenberg SJ, Scheinman MM, Dullet NK, Finkbeiner WE, Griffin JC, Eldar M, Franz MR, Gonzalez R, Kadish AH, Lesh MD: Sudden cardiac death and polymorphous ventricular tachycardia in patients with normal QT intervals and normal systolic function. Am J Cardiol 1995, 75:687-692. This paper describes a heterogenous group of adults without structural heart disease or QT prolongation who presented with polymorphous NSVT. Syncope and sudden death were frequent. Four groups were characterized: 1) those with exclusively exercise-induced polymorphous tachycardia, which was usually not pause dependent; 2) those with polymorphous NSVT associated with chest pain due to vasospasm; 3) those with nonexertional polymorphous ventricular tachycardia without preceding pauses; and 4) those with pause-dependent nonexertional polymorphous ventricular tachycardia.
21. Leenhardt A, Glaser E, Buguera M, Nurnberg M, Maison-Blanche P, Coumel PH: Short-coupled variant of torsades de pointes: an new electrocardiographic entity in the spectrum of idiopathic ventricular arrhythmias. Circulation 1994, 89:206-215.
22. Tamburro P, Wilber U: Sudden death in idiopathic dilated cardiomyopathy. Am Heart J 1992, 124:992-997.
23. Turitto G, Ahuja R, Caret EB, El-Sherif N: Risk stratification for arrhythmic events in patients with nonischemic dilated cardiomyopathy and NSVT: role of programmed ventricular stimulation and the signal-averaged electrocardiogram. J Am Coll Cardiol 1994, 24:1523-1528. In the largest study of patients with NSVT and idiopathic dilated cardiomyopathy, an abnormal signal-averaged ECG and inducible SMVT were infrequent but closely correlated. Neither finding predicted the subsequent occurrence of sustained ventricular arrhythmias or sudden death.
24. Mancini DM, Wong K, Simson MB: Prognostic value of an abnormal signal-averaged electrocardiogram In patients with nonischemic congestive cardiomyopathy. Circulation 1993, 87:1083-1092.
25. Spirito P, Rapezzi C, Autore C, Bruzzi P, Bellone P, Ortolani P, Fragola PV, Chiarella F, Zoni-Berisso M, Branzi A, Cannata D, Magnani B, Vecchio C: Prognosis of asymptomatic patients with hypertrophic cardiomyopathy and NSVT. Circulation 1994, 90:2743-2747. This study demonstrates that NSVT is common in asymptomatic older patients with hypertrophic cardiomyopathy. In contrast to younger and/or more symptomatic patients, NSVT was not associated with an increased risk of sudden death.
26. Poll DS, Marchlinski FE, Buxton AE, et al.: Usefulness of programmed stimulation in idiopathic dilated cardiomyopathy. Am J Cardiol 1986, 58:992-997.
27. Gossinger HD, Jung M, Wagner L, et al.: Prognostic role of inducible ventricular tachycardia in patients with dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia. Int J Cardiol 1990, 29:215-220.
28. Brembilla-Perrot B, Donetti J, Terrier de la Chaise A, et al. Diagnostic value of ventricular stimulation in patients with idiopathic dilated cardiomyopathy. Am Heart J 1991, 121:1124-1131.