Arrhythmias & electrophysiologyCohort study
Optimizing electrophysiology studies to prevent sudden cardiac death after myocardial infarction
- Prospective cohort study
- consecutive patients
Authors' conclusion
Ventricular tachycardia induced with shorter coupling intervals was associated with higher risk of spontaneous ventricular tachyarrhythymia on follow-up, indicating that the final extrastimulus coupling interval at EPS early after MI should be determined by ventricular refractoriness. Induced VT with possible origin from left ventricle was associated with increased risk of spontaneous ventricular tachyarrhythmia recurrence or death.
Study context
- Population
- Patients with left ventricular ejection fraction (LVEF) ≤ 40% undergoing electrophysiology study (EPS) days 3–5 after myocardial infarction (MI), 2004–2017
- Exposure
- <200 ms vs >200 ms
- Outcome
- Spontaneous ventricular tachyarrhythmia occurrence and all-cause mortality
Main finding
As reported in the abstract
Spontaneous ventricular tachyarrhythmia
P < 0.001
- Shorter coupling interval of final extrastimulus inducing ventricular tachycardia (VT) associated with higher risk of spontaneous ventricular tachyarrhythmia
- P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | HR | P value |
|---|---|---|
| All-cause mortality, RBBB morphology of induced VT (possible LV origin) | 3.2 | P = 0.044 |
| Spontaneous ventricular tachyarrhythmia recurrence or mortality, RBBB morphology of induced VT | 1.8 | P = 0.043 |
Original publication
Optimizing electrophysiology studies to prevent sudden cardiac death after myocardial infarction. Europace. Published 20 July 2023. doi:10.1093/europace/euad219
Summarised from the published abstract; every number is checked against it