Predictive Value of Ventricular Arrhythmia Inducibility for Subsequent Ventricular Tachycardia or Ventricular Fibrillation in Multicenter Automatic Defibrillator Implantation Trial (MADIT) II Patients

Daubert, James P.; Zaręba, Wojciech; Hall, William J.; Schuger, Claudio; Corsello, Andrew; León, Angel R.; Andrews, Mark; McNitt, Scott; Huang, David T.; Moss, Arthur J.; Investigators, Madit Ii Study

doi:10.1016/j.jacc.2005.08.049

Cited by 168 publications

(117 citation statements)

References 39 publications

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“…Various electric measures of arrhythmic risk, such as T-wave alternans, signal-averaged ECG, and electrophysiological study, have not demonstrated adequate or consistent discriminatory power. 4,5 Paradoxically, the mortality reduction benefit of primary prevention ICDs was established only when risk stratification was based on measures of left ventricular dysfunction and functional class (left ventricular ejection fraction Ͻ30% after myocardial infarction in MADIT II or left ventricular ejection fraction Ͻ35% with New York Heart Association class II to III in SCD-HeFT) rather than direct measures of arrhythmic risk.…”

Section: Article See P 835mentioning

confidence: 99%

Refining Patient Selection for Primary Prevention Implantable Cardioverter-Defibrillator Therapy

Tung

Swerdlow

2009

Circulation

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Section: Article See P 835mentioning

confidence: 99%

Refining Patient Selection for Primary Prevention Implantable Cardioverter-Defibrillator Therapy

Tung

Swerdlow

2009

Circulation

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“…In the MADIT II trial, patients with CAD and severely reduced LVEF (r30%) were randomized to ICD implantation or conventional therapy without requiring PES [9]. Nonetheless, PES was encouraged by the study committee, and 82% of the patients in the ICD arm underwent PES [12]. In the subgroup analysis, appropriate ICD therapy was more common in the inducible patients, but was still high in the non-inducible group (25.5% at two years).…”

Section: Discussionmentioning

confidence: 99%

Programmed electrical stimulation for risk stratification of patients with ischemic cardiomyopathy

Danon

Schliamser

Lavi

et al. 2014

Journal of Arrhythmia

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a b s t r a c tBackground: Patients with ischemic cardiomyopathy (ICM) are at an increased risk for sudden death. Although earlier trials used programmed electrical stimulation (PES) for risk stratification, more recent data demonstrate the benefit of implantable cardiac defibrillators (ICDs) in selected patients with reduced left ventricular ejection fraction (LVEF) without performing PES. However, little is known about the outcome of non-inducible patients. The purpose of this study was to evaluate the efficacy of PES for mortality risk stratification in patients with ICM. Methods: All consecutive patients who met the inclusion criteria (history of coronary artery disease, LVEF r 35%, and absence of documented spontaneous sustained ventricular tachycardia or aborted sudden cardiac death) were included in the study. The stimulation protocol involved up to three extrastimuli from two different sites in the right ventricle, with 180 ms as the shortest coupling interval. The primary endpoint was overall survival. Results: A total of 198 patients were included in the study; of these, 60 exhibited negative (À )PES, and 138 had positive (þ)PES and also underwent ICD implantation. The mean follow-up duration was 4.5 years. There was no difference in age or LVEF between the patient groups. We found a trend towards an increased 5-year survival rate in the (þ)PES group in whom ICD implantation had been performed (p¼ 0.058). Survival was significantly better in patients under 68 year olds in the (þ)PES group in whom ICD implantation was performed (hazard ratio¼ 0.3, p¼ 0.01). The survival rate of patients Z68 years old was similar in both groups (p¼0.95). Conclusions: Non-inducibility during PES does not predict the prognosis of patients with ischemic cardiomyopathy.

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“…The mechanisms underlying VF initiation are still poorly understood and how stable VT degenerates into VF is still not clear (Weiss et al 2000). Clinical trials have provided important information that tests used to induce VT in patients with prior MI and low left ventricular ejection fraction would predict future VT events but not necessary VF in patients with implantable cardioverter defibrillators (Daubert et al 2006). VF can arise without going through a period of stable VT and hence its initiation requires better understanding.…”

Section: Ventricular Arrhythmia Mechanisms and Sympathetic Activationmentioning

confidence: 99%

Neuro-cardiac interaction in malignant ventricular arrhythmia and sudden cardiac death

2016

Autonomic Neuroscience

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Sudden cardiac death as a result of lethal ventricular arrhythmias is a major cause of death in cardiac diseases such as heart failure and prior myocardial infarct. Activity of the autonomic nervous system is often abnormal where sympathetic activity is upregulated and vagal activity reduced in these conditions. The abnormal autonomic state has been shown to be a strong prognostic marker of increased mortality and propensity to lethal arrhythmias, for which there is no effective prevention. Research effort over the years has established good evidence for a causal link between autonomic disturbance and ventricular arrhythmias. However, the detailed electrophysiological mechanisms by which ventricular fibrillation occurs are still not clear and molecular processes which are modulated by autonomic nerve influences that either predispose the heart to or protect it from these arrhythmias are not fully understood. This review presents data from studies investigating the link between activity of the autonomic nervous system and ventricular arrhythmias, from seminal findings in classical studies to ongoing investigations, in the quest for a better understanding of the arrhythmogenic mechanisms underlying neurocardiac interactions with a view to the development of effective preventative and therapeutic strategies which are very much needed.

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Predictive Value of Ventricular Arrhythmia Inducibility for Subsequent Ventricular Tachycardia or Ventricular Fibrillation in Multicenter Automatic Defibrillator Implantation Trial (MADIT) II Patients

Cited by 168 publications

References 39 publications

Refining Patient Selection for Primary Prevention Implantable Cardioverter-Defibrillator Therapy

Refining Patient Selection for Primary Prevention Implantable Cardioverter-Defibrillator Therapy

Programmed electrical stimulation for risk stratification of patients with ischemic cardiomyopathy

Neuro-cardiac interaction in malignant ventricular arrhythmia and sudden cardiac death

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