Multicenter unsustained tachycardia trial mustt




















Hypothesis: Whether electrocardiographic characteristics of spontaneous nonsustained ventricular tachycardia can predict the inducibility of sustained ventricular tachycardia by programmed electrical stimulation in patients with coronary artery disease having abnormal ventricular function. Exclusions: Nonsustained ventricular tachycardia attributable to antiarrhythmic drugs, myocardial ischemia, or other metabolic derangements. Primary Endpoints: Arrhythmic death or cardiac arrest.

Secondary Endpoints: Overall mortality and cardiac mortality. Drugs to be used are procainamide, quinidine, disopyramide, propafenone, sotalol, amiodarone as monotherapy, or in combinations of quinidine or disopyramide plus mexiletine and procainamide or qu Concomitant Medications: All patients in the conservative group and EP-guided group received ACE inhibitors and beta-blockers.

Interpretation: In patients with asymptomatic nonsustained ventricular tachycardia, coronary artery disease, left ventricular ejection fraction. References: 1. Share via:. Media Center ACC. All rights reserved. Further studies are needed to confirm this finding and ensure that these results from are still valid on modern maximal medical therapies. Jump to: navigation , search.

Buxton AE et al. New Engl J Med. Non-cardiovascular e. Open in a separate window. All were followed prospectively. Thus, 94 patients experienced a cardiac arrest.

This classification was thus used only for this patient whose data was inadvertently apparent. See text. The inducible patients in this table declined randomization.

Thus, 57 of patients in this table experienced a cardiac arrest. Events Committee review The information provided to the Events Committee on each patient was reviewed by the full Committee at a periodic meeting, or was sent in rotation to two committee members.

Statistical methods and analysis The data are primarily tabular. Figure 1. Figure 2. Figure 3. The data in this table was subsequently tabulated by the data coordinating center. Figure 4. Table 4 Sudden Cardiac Death Definitions. Arrhythmic: abrupt loss of consciousness and collapse.

No prior circulatory impairment; collapse witnessed or not. Prior stable HF; collapse witnessed or not. Prior HF, worsening; collapse witnessed or not. Progressive circulatory failure.

Primarily peripheral failure; event witnessed or not. Primarily myocardial failure including acute infarction ; event witnessed or not. Events not classifiable. Table 6 Distribution of modes of death in some arrhythmia trials involving patients with ischemic heart disease. Footnotes Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. References 1. Nonsustained ventricular tachycardia in patients with coronary artery disease: relationship to inducible sustained ventricular tachycardia.

Ann Intern Med. Prediction of sustained ventricular tachycardia inducible by programmed stimulation in patients with coronary artery disease: Utility of clinical variables. A randomized study of the prevention of sudden death in patients with coronary artery disease.

N Engl J Med. Prediction of long-term outcomes by signal-averaged electrocardiography in patients with unsustained ventricular tachycardia, coronary artery disease, and left ventricular dysfunction. Differences in inducibility and prognosis of in-hospital versus out-of-hospital identified nonsustained ventricular tachycardia in patients with coronary artery disease: clinical and trial design implications.

J Am Coll Cardiol. J Cardiovasc Electrophysiol. Clinical classification of cardiac deaths. Classification of deaths after myocardial infarction as arrhythmic or non-arrhythmic. Mortality and morbidity in patients receiving encainide, flecainide, or placebo. An epidemiological study of sudden and unexpected deaths in adults. World Health Organization Scientific Group.

The pathological diagnosis of acute ischemic heart disease. WHO Rep Ser. Ventricular premature beats and mortality after myocardial infarction. Meyerburg RJ. Sudden death. J Cont Ed Cardiol. Goldstein S. The necessity of a uniform definition of sudden coronary death: witnessed death within one hour of the onset of acute symptoms. Am Heart J. Greene HL. Sudden arrhythmic cardiac death-mechanisms, resuscitation, and classification: the Seattle perspective. Recommended guidelines for reporting data from out-of-hospital cardiac arrest: the Utstein style.

Classification of death in patients under antiarrhythmic treatment. A new system for classification of cardiac death as arrhythmic, ischemic, or due to myocardial pump failure. Classification of death in antiarrhythmia trials. Marchlinski F. Predicting arrhythmic death: a plea for standardized reporting techniques and data based on continuous electrocardiographic monitoring.

Exploration of the precision of classifying sudden cardiac death. Accuracy and impact of presumed cause in patients with cardiac arrest. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Support Center Support Center. External link. Please review our privacy policy. Arrhythmic — Instant, after symptoms or signs of ischemia.



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