PROGNOSIS OF PATIENTS WITH A FIRST EPISODE OF SUSTAINED MONOMORPHIC VENTRICULAR-TACHYCARDIA

Aims: TO evaluate the cardiac mortality in patients suffering from a f irst episode of sustained monomorphic Ventricular tachycardia (SMVT). Methods: 100 patients less than 75 years old were evaluated during a 5 0-month follow-up period. Patients were classified into four groups: m yocardial infarction, dilated cardiomyopathy, normal heart and miscell any. Seventeen patients underwent a cardioverter-defibrillator implant ation, two heart transplant, three aneurysmectomy and 10 other types o f cardiac surgical proceedings. Results: Patients with a left ventricl e ejection fraction (EF)greater than or equal to 50% presented a cardi ac mortality of 5% compared with 38% of those with EF<50%. Etiology of underlying cardiomyopathy with an EF greater than or equal to 50% was associated with a cardiac mortality of 5% (normal heart), 5% (myocard ial infarction) and 9% (miscellany) compared to those with EF<50%: 33% (dilated cardiomyopathy) and 40% (myocardial infarction). Patients wh o experienced syncope during the first episode of SMVT showed a cardia c mortality of 31% compared to those 14% (P<0.05) who did not experien ce. Patients with syncope, myocardial infarction and EF<50% showed a c ardiac mortality of 68%. Conclusion: The present study shows that surv ival after the first episode of SMVT is closely related to EF and the existence of syncope. Patients with myocardial infarction and EF<50% h ad a worse prognosis when the site was the inferior wall. (C) 1998 Els evier Science Ireland Ltd.