PMID- 3415404
OWN - NLM
STAT- MEDLINE
DCOM- 19880928
LR  - 20071115
IS  - 0003-9926 (Print)
IS  - 0003-9926 (Linking)
VI  - 148
IP  - 9
DP  - 1988 Sep
TI  - Clinical predictors of electrophysiologic findings in patients with syncope of 
      unknown origin.
PG  - 1922-8
AB  - Unexplained syncope is a common medical problem. Intracardiac electrophysiologic 
      studies (EPS) have been used to uncover the underlying arrhythmic mechanisms. 
      Electrophysiologic studies are especially helpful in the management of patients 
      with inducible tachyarrhythmias, but is of limited usefulness in those with 
      normal EPS findings. We investigated whether clinical and noninvasive laboratory 
      variables can predict the results of EPS in 89 patients with unexplained syncope. 
      The prevalence of inducible ventricular tachycardia (VT) was 15%; 
      supraventricular tachycardia, 15%; bradyarrhythmias, 41%; and normal EPS, 29%. We 
      used multivariate discriminant function analysis to predict the results of EPS. 
      The variables selected for identification of patients with inducible VT by this 
      analysis include New York Heart Association (NYHA) functional class, gender, 
      digitalis use, nonsustained VT, and atrial fibrillation. Based on our statistical 
      model, performing EPS on 45% of the patients with unexplained syncope would 
      result in a 90% sensitivity in detecting patients with inducible VT. The 
      variables selected for identification of patients with normal EPS findings 
      include: New York Heart Association functional class, heart disease, digitalis 
      use, and intraventricular conduction. Based on this model, it would require that 
      all but 12% of patients with unexplained syncope be studied to achieve a 90% 
      predictive accuracy for identification of patients with normal EPS. During 
      follow-up, recurrence rates for the different EPS categories did not differ 
      significantly. The five-year cumulative survival among the EPS groups were as 
      follows: VT, 37% +/- 28%; SVT, 90% +/- 9%; bradyarrhythmias, 71% +/- 10%; and 
      normal EPS, 96% +/- 4%. Survival of the VT group differed significantly from that 
      of the normal group. In patients with unexplained syncope, EPS findings can be 
      predicted from clinical and noninvasive laboratory data. Mortality during 
      follow-up relates to EPS findings.
FAU - Denes, P
AU  - Denes P
AD  - Department of Medicine, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL 
      60612.
FAU - Uretz, E
AU  - Uretz E
FAU - Ezri, M D
AU  - Ezri MD
FAU - Borbola, J
AU  - Borbola J
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Arch Intern Med
JT  - Archives of internal medicine
JID - 0372440
RN  - 0 (Digitalis Glycosides)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Analysis of Variance
MH  - Arrhythmias, Cardiac/complications/mortality/physiopathology
MH  - Atrial Fibrillation/complications/mortality/physiopathology
MH  - Digitalis Glycosides/therapeutic use
MH  - Electric Stimulation
MH  - Electrocardiography
MH  - Electrophysiology/methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Diseases/*complications/drug therapy/mortality/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Probability
MH  - Sex Factors
MH  - Syncope/*etiology/physiopathology
MH  - Tachycardia/complications/mortality/physiopathology
EDAT- 1988/09/01 00:00
MHDA- 1988/09/01 00:01
CRDT- 1988/09/01 00:00
PHST- 1988/09/01 00:00 [pubmed]
PHST- 1988/09/01 00:01 [medline]
PHST- 1988/09/01 00:00 [entrez]
PST - ppublish
SO  - Arch Intern Med. 1988 Sep;148(9):1922-8.