caa a22 4500 477072542 CHVBK 20180405111430.0 cr unu---uuuuu 170330e19961101xx s 000 0 eng 10.1007/BF00050995 doi (NATIONALLICENCE)springer-10.1007/BF00050995 Programmed ventricular stimulation after myocardial infarction does not help reduce the risk of ventricular events [Elektronische Daten] [Béatrice Brembilla-Perrot, Laurent Jacquemin, Arnaud de la Chaise, Daniel Beurrier] Summary: Programmed ventricular stimulation could be a useful technique to detect patients at high risk for ventricular arrhythmias and sudden death after acute myocardial infarction. However, prevention of arrhythmic events using this technique has never been demonstrated. To determine whether prophylactic antiarrhythmic therapy influences prognosis after acute myocardial infarction, 196 patients without spontaneous ventricular tachycardia (VT) but with inducible sustained monomorphic VT were followed for 3±1 years. Ninety-seven patients were not treated (control group). In 99 patients (study group), the antiarrhythmic therapy was guided by electrophysiologic study: One to four trials using class I, II, and III antiarrhythmic drugs were performed until the VT was not inducible or the induced VT was slower and was associated with hemodynamic stability. An effective antiarrhythmic drug prevented VT induction in 34 patients (34%; group I). Sixty-five patients (group II) still had inducible VT with the antiarrhythmic drug. Group II differed from group I in having a higher incidence of an inferior myocardial infarction location (57% vs. 47%; NS), a lower left ventricular ejection fraction (36.5% vs. 41%; NS), a slower rate of induced VT in the control state (227 vs. 255 beats/min; p<0.05), and a higher number of drug trials (1.9 vs. 1.3; p<0.001). During the follow-up in the control group and in groups I and II, the incidence of total cardiac events was 25%, 15%, and 16% (NS), respectively, and the incidence of total arrhythmic events (VT, sudden death) was 18.5%, 9%, and 12% (NS). Only the risk of VT was reduced (14%, 0%, and 4%; p<0.05). In conclusion, guided-antiarrhythmic therapy, including class III agents after acute myocardial infarction, was successful in only 34% of patients, and the incidence of arrhythmic events was not significantly decreased. Therefore, programmed ventricular stimulation does not help in managing patients at risk of ventricular arrhythmia after myocardial infarction but could help to indicate the need for nonmedical treatment, such as device therapy. Kluwer Academic Publishers, 1996 antiarrhythmic drug nationallicence myocardial infarction nationallicence programmed ventricular stimulation nationallicence Brembilla-Perrot Béatrice Cardiology A-B, Chu of Brabois, Vandoeuvre, France aut Jacquemin Laurent Cardiology A-B, Chu of Brabois, Vandoeuvre, France aut de la Chaise Arnaud Cardiology A-B, Chu of Brabois, Vandoeuvre, France aut Beurrier Daniel Cardiology A-B, Chu of Brabois, Vandoeuvre, France aut Cardiovascular Drugs and Therapy Kluwer Academic Publishers 10/5(1996-11-01), 549-556 0920-3206 10:5<549 1996 10 10557 https://doi.org/10.1007/BF00050995 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF00050995 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Brembilla-Perrot Béatrice Cardiology A-B, Chu of Brabois, Vandoeuvre, France aut NATIONALLICENCE 700 1- Jacquemin Laurent Cardiology A-B, Chu of Brabois, Vandoeuvre, France aut NATIONALLICENCE 700 1- de la Chaise Arnaud Cardiology A-B, Chu of Brabois, Vandoeuvre, France aut NATIONALLICENCE 700 1- Beurrier Daniel Cardiology A-B, Chu of Brabois, Vandoeuvre, France aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Kluwer Academic Publishers 10/5(1996-11-01), 549-556 0920-3206 10:5<549 1996 10 10557 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer