Significance of inducible ventricular fibrillation in patients with coronary artery disease and unexplained syncope
Open accessAbstract
Objectives This study was designed to determine the incidence and prognostic significance of inducible ventricular fibrillation (VF) in patients with coronary artery disease (CAD) and unexplained syncope.Background Current American College of Cardiology/American Heart Association practice guidelines recommend implantation of internal cardioverter-defibrillators (ICDs) in patients with unexplained syncope in whom either ventricular tachycardia (VT) or VF is inducible during electrophysiologic (EP) testing. Although the prognostic significance of inducible monomorphic VT is known, the significance of inducible VF remains undefined.Methods We evaluated 118 consecutive patients with CAD and unexplained syncope who underwent EP testing. Sustained monomorphic VT was inducible in 53 (45%) patients; in 20 (17%) patients, VF was the only inducible arrhythmia; and no sustained ventricular arrhythmia was inducible in the remaining 45 (38%) patients. The latter two groups of 65 (55%) patients make up the study population.Results There were 16 deaths among the study population during a follow-up period of 25.3 +/- 19.6 months. The overall one- and two-year survival in these patients was 89% and 81%, respectively. No significant difference in survival was observed between patients with and without inducible VF (80% power to detect a fourfold survival difference).Conclusions In 17% of patients with CAD and unexplained syncope, VF is the only inducible ventricular arrhythmia. Within the limits of this pilot study, long-term follow-up of patients with and without inducible VF demonstrates no difference in survival between the two groups. Therefore, the practice of ICD implantation in patients with CAD, unexplained syncope and inducible VF, especially with triple ventricular extrastimuli, may merit reconsideration.
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In patients with a previous myocardial infarction and preserved left ventricular ejection fraction (LVEF), induction of sustained monomorphic VT is strongly predictive of the cause of syncope, whereas the induction of ventricular fibrillation (VF) is considered a non-specific finding.
“In patients with a previous myocardial infarction and preserved left ventricular ejection fraction (LVEF), induction of sustained monomorphic VT is strongly predictive of the cause of syncope, 218 whereas the induction of ventricular fibrillation (VF) is considered a non-specific finding. 37”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [37]
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Gregoratos, G., Cheitlin, M. D., Conill, A., Epstein, A. E., Fellows, C., Ferguson, T. B., Freedman, R. A., Hlatky, M. A., Naccarelli, G. V., Saksena, S. V., et al. (1998) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)00024-2 · Cited by 632 · see citing works
Buxton, A. E., Lee, K. L., DiCarlo, L. A., Gold, M. R., Greer, G. S., Prystowsky, E. N., O’Toole, M. F., TANG, A. S. L., Fisher, J. D., Coromilas, J., et al. (2000) · New England Journal of Medicine · doi:10.1056/nejm200006293422602 · Cited by 564 · see citing works
Denniss, A. R., Richards, D. A., Cody, D. V., Russell, P. A., Young, A. A., Cooper, M. J., Ross, D. L., & Uther, J. B. (1986) · Circulation · doi:10.1161/01.cir.74.4.731 · Cited by 450 · see citing works
Wellens, H. J. J., Brugada, P., & Stevenson, W. G. (1985) · Circulation · doi:10.1161/01.cir.72.1.1 · Cited by 308 · see citing works
Brugada, P., Green, M. S., Abdollah, H., & Wellens, H. J. J. (1984) · Circulation · doi:10.1161/01.cir.69.1.87 · Cited by 308 · see citing works
Gregoratos, G., Conill, A. M., Hlatky, M. A., Fellows, C., Silka, M. J., Ritchie, J., Eagle, K., Ryan, T., & Garson, A. (1998) · Journal of the American College of Cardiology · Cited by 306 · see citing works
Unexplained Syncope Evaluated by Electrophysiologic Studies and Head-up Tilt Testing
SRA, J. S., Anderson, A. J., Sheikh, S. H., Avitall, B., TCHOU, P. J., Troup, P. J., Gilbert, C. J., Akhtar, M., & Jazayeri, M. R. (1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-114-12-1013 · Cited by 219 · see citing works
Knight, B. P., Goyal, R., Pelosi, F., Flemming, M. A., Horwood, L. E., Morady, F., & Strickberger, S. A. (1999) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(99)00148-5 · Cited by 216 · see citing works
PBrugada, MGreen, HAbdollah, et al. (1984) · Circulation · Cited by 156 · see citing works
Electrophysiologic testing in the evaluation of patients with syncope of undetermined origin
Hess, D., Morady, F., & Scheinman, M. M. (1982) · The American Journal of Cardiology · doi:10.1016/0002-9149(82)90468-4 · Cited by 155 · see citing works
Doherty, J. U., Pembrook-Rogers, D., Grogan, E., Falcone, R. A., Buxton, A. E., Marchlinski, F. E., Cassidy, D. M., Kienzle, M. G., Almendral, J. M., & Josephson, M. E. (1985) · The American Journal of Cardiology · doi:10.1016/0002-9149(85)90140-7 · Cited by 138 · see citing works
Electrophysiologic testing in bundle branch block and unexplained syncope
Morady, F., Higgins, J., Peters, R. W., Schwartz, A. B., Shen, E. N., Bhandari, A., Scheinman, M. M., & Sauvé, M. J. (1984) · The American Journal of Cardiology · doi:10.1016/0002-9149(84)90254-6 · Cited by 138 · see citing works
Król, R. B., Morady, F., Flaker, G. C., DiCarlo, L. A., Baerman, J. M., Hewett, J. E., & de Buitleir, M. (1987) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(87)80019-0 · Cited by 137 · see citing works
Role of Cardiac Electrophysiologic Studies in Patients with Unexplained Recurrent Syncope
Akhtar, M., Shenasa, M., Denker, S. T., Gilbert, C. J., & RIZWI, N. (1983) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1983.tb04346.x · Cited by 131 · see citing works
Olshansky, B., Mazuz, M., & Martins, J. B. (1985) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(85)80040-1 · Cited by 125 · see citing works
The value of electrophysiologic studies in syncope of undetermined origin: Report of 150 cases
Teichman, S. L., Felder, S. D., Matos, J. A., Kim, S. G., Waspe, L. E., & Fisher, J. D. (1985) · American Heart Journal · doi:10.1016/0002-8703(85)90171-1 · Cited by 113 · see citing works
ACC/AHA Guidelines for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices
Gregoratas, G., Cheitlin, Conill, A. M., Ae, E., Fellows, C., Ferguson, T. B. B., Ra, F., Hlatky, M. A., Naccarelli, G. V., & Saksena, S. V. (1998) · Cited by 113 · see citing works
Long-term prognosis of patients undergoing electrophysiologic studies for syncope of unknown origin
Bass, E. B., Elson, J. J., Fogoros, R. N., Peterson, J., Arena, V. C., & Kapoor, W. N. (1988) · The American Journal of Cardiology · doi:10.1016/0002-9149(88)90257-3 · Cited by 103 · see citing works
Link, M. S., Costeas, X. F., Griffith, J. L., Colburn, C., Estes, N. A. M., & Wang, P. J. (1997) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(96)00477-9 · Cited by 77 · see citing works
Andrews, N. P., Fogel, R. I., Pelargonio, G., Evans, J. J., & Prystowsky, E. N. (1999) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(99)00465-9 · Cited by 71 · see citing works
Mittal, S., Iwai, S., Steín, K. M., Markowitz, S. M., Slotwiner, D. J., & Lerman, B. B. (1999) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(99)00323-x · Cited by 66 · see citing works
Self-citationBourke, J. P., Richards, D. A. B., Ross, D. L., et al. (1995) · The American Journal of Cardiology · doi:10.1016/s0002-9149(99)80576-1 · Cited by 61 · see citing works
DiCarlo, L. A., Morady, F., Schwartz, A. B., et al. (1985) · American Heart Journal · doi:10.1016/0002-8703(85)90235-2 · Cited by 61 · see citing works
Induction of Neurally Mediated Syncope With Adenosine
Mittal, S., Steín, K. M., Markowitz, S. M., Slotwiner, D. J., Rohatgi, S., & Lerman, B. B. (1999) · Circulation · doi:10.1161/01.cir.99.10.1318 · Cited by 55 · see citing works
Self-citationElectrophysiologic studies in patients with unexplained syncope
Denniss, A. R., Ross, D. L., Richards, D. A., & Uther, J. B. (1992) · International Journal of Cardiology · doi:10.1016/0167-5273(92)90179-7 · Cited by 52 · see citing works
Moazez, F., Peter, T. C., Simonson, J. S., et al. (1991) · American Heart Journal · doi:10.1016/0002-8703(91)90959-l · Cited by 50 · see citing works
MILITIANU, A., SALACATA, A., SEIBERT, K., KEHOE, R., BAGA, J. J., MEISSNER, M. D., PIRES, L. A., SCHUGER, C. D., STEINMAN, R. T., MOSTELLER, R. D., et al. (1997) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1997.tb00994.x · Cited by 50 · see citing works
Electrophysiologic evaluation and outcome of patients with syncope of unknown origin
MULLER, T., Roy, D., Talajic, M. R., Lemery, R., Nattel, S., & Cassidy, D. M. (1991) · European Heart Journal · doi:10.1093/oxfordjournals.eurheartj.a059859 · Cited by 41 · see citing works
Regulation of adenylyl cyclase by noradrenaline and tumour necrosis factor in rat cardiomyocytes
Reithmann, C., Gierschik, P., Jakobs, K. H., & Werdan, K. (1991) · European Heart Journal · doi:10.1093/eurheartj/12.suppl_f.139 · Cited by 37 · see citing works
Lippman, N., Steín, K. M., & Lerman, B. B. (1994) · American Heart Journal · doi:10.1016/0002-8703(94)90741-2 · Cited by 29 · see citing works
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Research works printed but not linked: 1
- Mittal S, Stephenson K, Stein KM, et al. Long-term outcome of patients with a non-ischemic cardiomyopathy and unexplained syn- cope. Pacing Clin Electrophysiol 2000;23:560.
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Developed in collaboration with, European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), and Heart Rhythm Society (HRS), societies, E. B. T. F., European Society of Emergency Medicine (EuSEM), European Federation of Internal Medicine (EFIM), European Union Geriatric Medicine Society (EUGMS), American Geriatrics Society (AGS), European Neurological Society (ENS), et al. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp298 · Cited by 2,040 · see citing works
2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya, A., de Lange, F. J., Deharo, J.-C., Elliott, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martín, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy037 · Cited by 1,951 · see citing works
SHELDON, R., HERSI, A., RITCHIE, D., KOSHMAN, M., & ROSE, S. (2010) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2010.01835.x · Cited by 61 · see citing works
Brembilla-Perrot, B., Suty-Selton, C., Beurrier, D., Houriez, P., Nippert, M., Terrier de la Chaise, A., Louis, P., Claudon, O., Andronache, M., Abdelaah, A., et al. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.03.075 · Cited by 49 · see citing works
Blanc, J.-J. (2013) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2012.11.002 · Cited by 29 · see citing works
- Authors
- Mittal, S., Hao, S. C., Iwai, S., Stein, K. M., Markowitz, S. M., Slotwiner, D. J., & Lerman, B. B.
- Corresponding author
- Lerman, Bruce B
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2001-08
- Volume
- 38
- Issue
- 2
- Pages
- 371-376
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2126281279
- Cited by
- 49
- References
- 30
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 4 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 1 · 2014: 3 · 2013: 7
- FWCI
- 2.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- National Institutes of Health
- National Heart, Lung, and Blood Institute (R01HL056139, R01HL56139)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- coronary artery disease, unexplained syncope, implantable cardioverter-defibrillator, ICD implantation, electrophysiologic testing, monomorphic ventricular tachycardia, survival, prognosis, ventricular arrhythmias
- MeSH terms
- Aged, Coronary Disease, Female, Follow-Up Studies, Humans, Male, Middle Aged, Pacemaker, Artificial, Pilot Projects, Prognosis, Syncope, Ventricular Fibrillation, Incidence, Survival Rate, Defibrillators, Implantable, Electrophysiologic Techniques, Cardiac
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