Predictors of arrhythmic death and cardiac arrest in the ESVEM trial

Anthony C. Caruso, Frank I. Marcus*, Elizabeth A. Hahn, Vernon L. Hartz, Jay W. Mason

*Corresponding author for this work

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Background: The purpose of this study was to determine if the presenting ventricular arrhythmia (ventricular tachycardia or ventricular fibrillation/cardiac arrest) predicted the type of arrhythmia recurrence in patients treated with antiarrhythmic drugs. Methods and Results: In the previously reported Electrophysiologic Study Versus Electrocardiographic Monitoring (ESVEM) trial, there were 486 patients who were randomized to antiarrhythmic drug testing guided by electrophysiological study or by ambulatory ECG monitoring. Use of a defibrillator (implantable cardioverter- defibrillator, ICD) without stored electrograms among 81 patients precluded determination of the type of arrhythmia recurrence; thus these patients were censored at the time of ICD implantation. Of the 486 patients, 381 presented with ventricular tachycardia and 105 with cardiac arrest. Over a 6-year follow-up period, 285 of the 486 patients had an arrhythmia recurrence; of these, 97 had an arrhythmic death or cardiac arrest as a first recurrence. In the current analysis, all 129 arrhythmic deaths/cardiac arrests that occurred any time during follow-up were evaluated as end points. Conclusions: Although univariate analysis suggested that there was an association between the presenting arrhythmia and outcome, multivariate analysis failed to substantiate the predictive value of the presenting arrhythmia. Left ventricular ejection fraction was the single most important predictor of arrhythmic death or cardiac arrest. This information may be an important factor in deciding whether to advise ICD therapy.

Original languageEnglish (US)
Pages (from-to)1888-1892
Number of pages5
JournalCirculation
Volume96
Issue number6
DOIs
StatePublished - Sep 16 1997

Fingerprint

Heart Arrest
Cardiac Arrhythmias
Implantable Defibrillators
Recurrence
Anti-Arrhythmia Agents
Ventricular Tachycardia
Ambulatory Monitoring
Defibrillators
Ventricular Fibrillation
Stroke Volume
Electrocardiography
Multivariate Analysis

Keywords

  • Antiarrhythmia agents
  • Arrhythmia
  • Defibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Caruso, A. C., Marcus, F. I., Hahn, E. A., Hartz, V. L., & Mason, J. W. (1997). Predictors of arrhythmic death and cardiac arrest in the ESVEM trial. Circulation, 96(6), 1888-1892. https://doi.org/10.1161/01.CIR.96.6.1888
Caruso, Anthony C. ; Marcus, Frank I. ; Hahn, Elizabeth A. ; Hartz, Vernon L. ; Mason, Jay W. / Predictors of arrhythmic death and cardiac arrest in the ESVEM trial. In: Circulation. 1997 ; Vol. 96, No. 6. pp. 1888-1892.
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Caruso, AC, Marcus, FI, Hahn, EA, Hartz, VL & Mason, JW 1997, 'Predictors of arrhythmic death and cardiac arrest in the ESVEM trial', Circulation, vol. 96, no. 6, pp. 1888-1892. https://doi.org/10.1161/01.CIR.96.6.1888

Predictors of arrhythmic death and cardiac arrest in the ESVEM trial. / Caruso, Anthony C.; Marcus, Frank I.; Hahn, Elizabeth A.; Hartz, Vernon L.; Mason, Jay W.

In: Circulation, Vol. 96, No. 6, 16.09.1997, p. 1888-1892.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predictors of arrhythmic death and cardiac arrest in the ESVEM trial

AU - Caruso, Anthony C.

AU - Marcus, Frank I.

AU - Hahn, Elizabeth A.

AU - Hartz, Vernon L.

AU - Mason, Jay W.

PY - 1997/9/16

Y1 - 1997/9/16

N2 - Background: The purpose of this study was to determine if the presenting ventricular arrhythmia (ventricular tachycardia or ventricular fibrillation/cardiac arrest) predicted the type of arrhythmia recurrence in patients treated with antiarrhythmic drugs. Methods and Results: In the previously reported Electrophysiologic Study Versus Electrocardiographic Monitoring (ESVEM) trial, there were 486 patients who were randomized to antiarrhythmic drug testing guided by electrophysiological study or by ambulatory ECG monitoring. Use of a defibrillator (implantable cardioverter- defibrillator, ICD) without stored electrograms among 81 patients precluded determination of the type of arrhythmia recurrence; thus these patients were censored at the time of ICD implantation. Of the 486 patients, 381 presented with ventricular tachycardia and 105 with cardiac arrest. Over a 6-year follow-up period, 285 of the 486 patients had an arrhythmia recurrence; of these, 97 had an arrhythmic death or cardiac arrest as a first recurrence. In the current analysis, all 129 arrhythmic deaths/cardiac arrests that occurred any time during follow-up were evaluated as end points. Conclusions: Although univariate analysis suggested that there was an association between the presenting arrhythmia and outcome, multivariate analysis failed to substantiate the predictive value of the presenting arrhythmia. Left ventricular ejection fraction was the single most important predictor of arrhythmic death or cardiac arrest. This information may be an important factor in deciding whether to advise ICD therapy.

AB - Background: The purpose of this study was to determine if the presenting ventricular arrhythmia (ventricular tachycardia or ventricular fibrillation/cardiac arrest) predicted the type of arrhythmia recurrence in patients treated with antiarrhythmic drugs. Methods and Results: In the previously reported Electrophysiologic Study Versus Electrocardiographic Monitoring (ESVEM) trial, there were 486 patients who were randomized to antiarrhythmic drug testing guided by electrophysiological study or by ambulatory ECG monitoring. Use of a defibrillator (implantable cardioverter- defibrillator, ICD) without stored electrograms among 81 patients precluded determination of the type of arrhythmia recurrence; thus these patients were censored at the time of ICD implantation. Of the 486 patients, 381 presented with ventricular tachycardia and 105 with cardiac arrest. Over a 6-year follow-up period, 285 of the 486 patients had an arrhythmia recurrence; of these, 97 had an arrhythmic death or cardiac arrest as a first recurrence. In the current analysis, all 129 arrhythmic deaths/cardiac arrests that occurred any time during follow-up were evaluated as end points. Conclusions: Although univariate analysis suggested that there was an association between the presenting arrhythmia and outcome, multivariate analysis failed to substantiate the predictive value of the presenting arrhythmia. Left ventricular ejection fraction was the single most important predictor of arrhythmic death or cardiac arrest. This information may be an important factor in deciding whether to advise ICD therapy.

KW - Antiarrhythmia agents

KW - Arrhythmia

KW - Defibrillation

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