Role of Electrophysiologic Study (EPS)-Guided Preventive Therapy for the Management of Ventricular Tachyarrhythmias in Patients With Heart Failure

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  • Niwano Shinichi
    Department of Cardio-angiology, Kitasato University School of Medicine
  • Fukaya Hidehira
    Department of Cardio-angiology, Kitasato University School of Medicine
  • Yuge Masaru
    Department of Cardio-angiology, Kitasato University School of Medicine
  • Imaki Ryuta
    Department of Cardio-angiology, Kitasato University School of Medicine
  • Hirasawa Shouji
    Department of Cardio-angiology, Kitasato University School of Medicine
  • Sasaki Takeshi
    Department of Cardio-angiology, Kitasato University School of Medicine
  • Yumoto Yoshihiro
    Department of Cardio-angiology, Kitasato University School of Medicine
  • Inomata Takayuki
    Department of Cardio-angiology, Kitasato University School of Medicine
  • Izumi Tohru
    Department of Cardio-angiology, Kitasato University School of Medicine

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Background Ventricular tachyarrhythmias (VT/VF) are 1 of the most important factors determining the prognosis of patients with heart failure (HF). Although priority is given to implantable cardioverter defibrillator (ICD) therapy for the prevention of sudden cardiac death, electrophysiologic-study (EPS)-guided preventive therapy could be important for reducing the number of cardiac events. Methods and Results Of 864 patients with a history of HF, an EPS was performed in 168 and 121 had inducible VT/VF. Under the basic therapy of an ICD, additional catheter ablation was attempted for 95 of 124 monomorphic VT foci in 74 patients, and 78 of the VT were successfully ablated. The prognoses were compared among 5 patient groups with different results for the EPS and catheter ablation: (1) success group (n=43), (2) failure group (n=15), (3) not attempted group (n=16), (4) VF group (n=47), and (5) no inducible VT/VF group. During a follow-up period of 31±22 months, the incidence of VT/VF was lower in the success and no inducible VT/VF groups than in the other groups (p=0.0018), although a significant difference was not observed for the total deaths. Conclusion EPS-guided preventive therapy using an ICD and catheter ablation can be useful, at least for the reduction of arrhythmic events in patients with HF. (Circ J 2008; 72: 268 - 273)<br>

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  • Circulation Journal

    Circulation Journal 72 (2), 268-273, 2008

    一般社団法人 日本循環器学会

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