Utility of electrophysiological studies to predict arrhythmic events

Hilfiker, Gabriela; Schoenenberger, Andreas; Erne, Paul; Kobza, Richard (2015). Utility of electrophysiological studies to predict arrhythmic events. World journal of cardiology, 7(6), pp. 344-350. Baishideng Publishing Group 10.4330/wjc.v7.i6.344

[img]
Preview
Text
WJC-7-344.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC).
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

Download (815kB) | Preview

AIM To evaluate the prognostic value of electrophysiological stimulation (EPS) in the risk stratification for tachyarrhythmic events and sudden cardiac death (SCD). METHODS We conducted a prospective cohort study and analyzed the long-term follow-up of 265 consecutive patients who underwent programmed ventricular stimulation at the Luzerner Kantonsspital (Lucerne, Switzerland) between October 2003 and April 2012. Patients underwent EPS for SCD risk evaluation because of structural or functional heart disease and/or electrical conduction abnormality and/or after syncope/cardiac arrest. EPS was considered abnormal, if a sustained ventricular tachycardia (VT) was inducible. The primary endpoint of the study was SCD or, in implanted patients, adequate ICD-activation. RESULTS During EPS, sustained VT was induced in 125 patients (47.2%) and non-sustained VT in 60 patients (22.6%); in 80 patients (30.2%) no arrhythmia could be induced. In our cohort, 153 patients (57.7%) underwent ICD implantation after the EPS. During follow-up (mean duration 4.8 ± 2.3 years), a primary endpoint event occurred in 49 patients (18.5%). The area under the receiver operating characteristic curve (AUROC) was 0.593 (95%CI: 0.515-0.670) for a left ventricular ejection fraction (LVEF) < 35% and 0.636 (95%CI: 0.563-0.709) for inducible sustained VT during EPS. The AUROC of EPS was higher in the subgroup of patients with LVEF ≥ 35% (0.681, 95%CI: 0.578-0.785). Cox regression analysis showed that both, sustained VT during EPS (HR: 2.26, 95%CI: 1.22-4.19, P = 0.009) and LVEF < 35% (HR: 2.00, 95%CI: 1.13-3.54, P = 0.018) were independent predictors of primary endpoint events. CONCLUSION EPS provides a benefit in risk stratification for future tachyarrhythmic events and SCD and should especially be considered in patients with LVEF ≥ 35%.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Geriatric Clinic

UniBE Contributor:

Schoenenberger, Andreas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1949-8462

Publisher:

Baishideng Publishing Group

Language:

English

Submitter:

Rebecca Rufer

Date Deposited:

30 Mar 2016 08:12

Last Modified:

02 Apr 2016 01:44

Publisher DOI:

10.4330/wjc.v7.i6.344

PubMed ID:

26131339

Uncontrolled Keywords:

Arrhythmia; Cardiac; Electrophysiologic techniques; Sudden cardiac death

BORIS DOI:

10.7892/boris.77257

URI:

https://boris.unibe.ch/id/eprint/77257

Actions (login required)

Edit item Edit item
Provide Feedback