What is the risk of sudden cardiac death in patients presenting with hemodynamically stable sustained ventricular tachycardia after myocardial infarction?

Abstract

Although the overall mortality in postinfarction patients presenting with hemodynamically stable ventricular tachycardia treated with electrophysiologically guided antiarrhythmic therapy is high, the risk of sudden death in these patients appears to be low (average 2.4%/year).

Hidden Cardiac Lesions and Psychotropic Drugs as a Possible Cause of Sudden Death in Psychiatric Patients: A Report of 14 Cases and Review of the Literature

“…The risk of sudden death is not increased with monomorphic tachyarrhythmia but markedly increased with polymorphic tachyarrhythmia. When tachyarrhythmia results in hemodynamic instability, the risk of sudden death in patients is increased (37). The preexistence of right ventricular dysplasia, hypertrophic cardiomyopathy, and Brugada syndrome (right branch block associated with ST accentuation) (38) is associated with a high risk of cardiac arrhythmia.…”

Implantable Cardioverter-Defibrillator Therapy for Prevention of Sudden Death in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia

“…17 In patients with ARVC/D, ventricular fibrillation has been associated with active phases of myocyte death occurring in younger affected patients with progressive disease, whereas hemodynamically well-tolerated monomorphic ventricular tachycardia is caused by a reentry mechanism around a stable myocardial scar as the result of a healing process that occurs in a later stage of the disease course. 2,[3][4][5]18,19 This view is reinforced by the present finding that younger age is an independent risk factor for ventricular fibrillation/flutter.…”

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

“…Patients who present with sustained monomorphic VT that does not precipitate cardiac arrest or cause severe hemodynamic instability are usually, but not always, at relatively low risk for SCD (2% yearly) (399,400). Twelve-lead ECGs should be obtained during episodes of sustained VT, and the morphology assessed to be certain that it is consistent with location of prior MI(s).…”