ANGIOGRAPHIC LEFT-VENTRICULAR WALL-MOTION SCORE TO PREDICT ARRHYTHMIARECURRENCE IN PATIENTS WITH SUSTAINED VENTRICULAR-TACHYCARDIA OR FIBRILLATION

Methods Sixty-nine patients with sustained ventricular tachyarrhythmia s were followed up to evaluate the predictive value of functional capa city (i.e. New York Heart Association class and peak oxygen consumptio n) and resting left ventricular function (i.e. radionuclide left ventr icular ejection fraction, angiographic left ventricular wall motion sc ore and echocardiographic dimensions) with respect to arrhythmia recur rence. Results During a mean follow-up of 19 months 18 patients (26%) had an arrhythmia recurrence. Parameters of functional capacity and ec hocardiographic dimensions were not related to arrhythmia recurrence. Left ventricular ejection fraction and wall motion score were worse in patients with a recurrence compared with the arrhythmia-free patients : 30 +/- 16% versus 40 +/- 19% (mean +/- SD, P = 0.035) and 25 +/- 7 v ersus 20 +/- 7 (P = 0.01), respectively. Multivariately the most power ful parameter was left ventricular wall motion score (odds ratio 1.12, 95% CI 1.02-1.23). Conclusions Arrhythmia recurrence in ventricular t achyarrhythmia patients relates to resting left ventricular function a nd not to functional capacity. Since angiographic left ventricular wal l motion score is prognostically more important than ejection fraction this parameter should be considered for risk stratification in these patients.