PMID- 15226627
OWN - NLM
STAT- MEDLINE
DCOM- 20050415
LR  - 20190819
IS  - 1346-9843 (Print)
IS  - 1346-9843 (Linking)
VI  - 68
IP  - 7
DP  - 2004 Jul
TI  - Different predictive values of electrophysiological testing and autonomic 
      assessment in patients surviving a sustained arrhythmic episode.
PG  - 634-8
AB  - BACKGROUND: Recent data suggest that the electrophysiological study (EPS) has 
      limited value in the identification of high risk patients, so the aim of the 
      present study was to evaluate if non-invasive measurement of baroreflex 
      sensitivity (BRS), a marker of autonomic balance, provides additional prognostic 
      information in patients surviving a sustained arrhythmic episode. METHODS AND 
      RESULTS: The study group comprised 112 post myocardial infarction patients 
      consecutively referred for EPS following documented ventricular fibrillation (VF) 
      (20), sustained ventricular tachycardia (VT) (74) or a syncopal episode with 
      subsequently documented non-sustained VT at Holter monitoring (18). BRS was 
      assessed according to the transfer function method. A cardioverter - 
      defibrillator (ICD) was implanted in 97 patients. During follow-up (median 315 
      days), appropriate ICD discharge occurred in 53 patients, and 3 more patients 
      died suddenly. Sustained VT was induced in 84% and 77% of patients who did or did 
      not develop arrhythmia at follow-up (p=0.34). No differences were found in age, 
      sex, infarct site, drug therapy, resting RR interval or cycle of induced VT. Left 
      ventricular ejection fraction (LVEF) < or =35%, New York Heart Association (NYHA) 
      class >2 and BRS < or =3.3 ms/mmHg were found to be univariate predictors of 
      arrhythmia recurrence. Multivariate models were obtained after grouping patients 
      according to a moderately or severely depressed LVEF. Among the patients with 
      LVEF < or =35%, BRS < or =3.3 ms/mmHg emerged as the only significant risk 
      predictor of arrhythmia occurrence (sensitivity, specificity, positive and 
      negative predictive value = 79%, 74%, 83% and 68%, respectively), whereas NYHA 
      class >2 was a significant predictor among patients with LVEF >35%. CONCLUSIONS: 
      Noninvasive BRS, but not EPS, is of value in predicting VT/VF episode recurrence 
      in patients surviving a major arrhythmic event.
FAU - Raczak, Grzegorz
AU  - Raczak G
AD  - II Department of Cardiology, Medical University of Gdansk, Poland. 
      gracz@amg.gda.pl
FAU - Pinna, Gian Domenico
AU  - Pinna GD
FAU - Maestri, Roberto
AU  - Maestri R
FAU - Danilowicz-Szymanowicz, Ludmila
AU  - Danilowicz-Szymanowicz L
FAU - Szwoch, Malgorzta
AU  - Szwoch M
FAU - Lubinski, Andrzej
AU  - Lubinski A
FAU - Kempa, Maciej
AU  - Kempa M
FAU - La Rovere, Maria Teresa
AU  - La Rovere MT
FAU - Swiatecka, Grazyna
AU  - Swiatecka G
LA  - eng
PT  - Journal Article
PL  - Japan
TA  - Circ J
JT  - Circulation journal : official journal of the Japanese Circulation Society
JID - 101137683
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Anti-Arrhythmia Agents)
RN  - N3RQ532IUT (Amiodarone)
SB  - IM
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Amiodarone/therapeutic use
MH  - Anti-Arrhythmia Agents/therapeutic use
MH  - Arrhythmias, Cardiac/*diagnosis/mortality/*physiopathology
MH  - Baroreflex/physiology
MH  - Death, Sudden, Cardiac
MH  - Electrophysiology/methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Survival Analysis
EDAT- 2004/07/01 05:00
MHDA- 2005/04/16 09:00
CRDT- 2004/07/01 05:00
PHST- 2004/07/01 05:00 [pubmed]
PHST- 2005/04/16 09:00 [medline]
PHST- 2004/07/01 05:00 [entrez]
AID - 10.1253/circj.68.634 [doi]
PST - ppublish
SO  - Circ J. 2004 Jul;68(7):634-8. doi: 10.1253/circj.68.634.