engleski

Therapeutic approach to asymptomatic nonsustained ventricular tachycardia

EPS was performed in 120 consecutive Pts with asymptomatic NSVT after MI and ejection fraction <40%. Eighty two Pts had noniducible (Group I) and 48 Pts had inducible (Group II) sustained monomorphic VT. In group I, 46 Pts were discharged on no drug therapy and 36 Pts on beta-blockers. In group II, 23 Pts with inducible VT were discharged on drug therapy, resulting in suppression of inducible VT, and 25 Pts with inducible and nonsuppressed VT on empiric drug therapy. Results. During a mean follow-up of 24 months, there were 12 hemodinamically unstable VT and/or sudden deaths. In group I, the 2-year acturial incidence of these events was 10% in Pts with no therapy, and 3% in Pts treated with betablockers. In group II, the 2-years acturial incidence of arrhythmic events was 7% in Pts in whom inducible VT was suppressed, and 37% in Pts with inducible and nonsuppressed VT. Conclusion: Pts with asymptomatic NSVT after MI and ejection fraction <40% should be recommended for EPS evaluation. Pts with noniducible sustained monomorphic VT may be followed without antiarrhythmics, and Pts with inducible and suppressed VT may be treated by effective drugs. Pts in whom inducible VT can not be suppressed by antiarrhythmic drugs have high risk for subsequent sudden death and require nonpharmacological therapy.

nonsustained VT; electropharmacological study; myocardial infarction

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