EVALUATION OF END-POINTS OF SERIAL DRUG-TESTING IN PATIENTS WITH SUSTAINED VENTRICULAR-TACHYCARDIA AFTER HEALING OF ACUTE MYOCARDIAL-INFARCTION

Serial electrophysiologic drug testing was used to guide antiarrhythmi c therapy in a consecutive series of 150 patients with clinical sustai ned ventricular tachycardia [VT] or cardiac arrest and inducible monom orphic VT. All patients had coronary artery disease and a history of m yocardial infarction. For patients with clinical sustained VT, drug re sponders and partial drug responders (VT slowed by drug to rate <150 b eats/min, with systolic blood pressure greater than or equal to 90 mm Tig) had similar total mortality rates (2-year actuarial survival 100% and 94%, p = NS), which were statistically different from that of pat ients with drug inefficacy (2-year survival 67%). Partial drug respond ers had high arrhythmia recurrence rates, similar to those of patients with drug inefficacy. For cardiac arrest survivors, the results of el ectrophysiologically guided drug testing did not predict prognosis. Pa tients with a change in mode a) VT induction during antiarrhythmic the rapy had a favorable prognosis (no deaths during follow-up).