Idiopathic dilated cardiomyopathy. Role of programmed electrical stimulation and holter monitoring in predicting those at risk of sudden death

J. Kron, M. Hart, S. Schual-Berke, N. R. Niles, J. D. Hosenpud, J. H. McAnulty

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

Abstract

The prognostic role of programmed electrical stimulation and Holter monitoring was evaluated in 21 patients with idiopathic dilated cardiomyopathy who had no prior history of ventricular tachyarrhythmias. During a mean follow-up period of 23 months, sudden death or ventricular fibrillation occurrred in four (20 percent). One patient died of complications of sepsis, and one underwent cardiac transplantation. Programmed electrical stimulation (PES) resulted in five or more beats of induced ventricular tachycardia in seven patients (33 percent), but was a poor predictor of sudden death (sensitivity = 20 percent). Thirteen patients (62 percent) had complex ventricular ectopy (Lown class 4A or 4B by ambulatory monitoring. This was a sensitive )80 percent) but not specific (31 percent) marker for sudden death. The predictive value of a negative Holter monitor study was high (80 percent) for identifying those at low risk of sudden death. The results of this prospective study suggest that programmed ventricular stimulation and routine ambulatory monitoring are poor predictors of sudden death in this population.

Original languageEnglish (US)
Pages (from-to)85-90
Number of pages6
JournalCHEST
Volume93
Issue number1
DOIs
StatePublished - Jan 1 1988

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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