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Rolf S, Haverkamp W. Grenzen und Möglichkeiten der invasiven Risikostratifikation : Brauchen wir die programmierte Elektrostimulation noch? [Limits and scopes of invasive risk stratification. Do we still need programmed ventricular stimulation?]. Herz. 2009;34(7):528-38doi: 10.1007/s00059-009-3294-6.
Rolf, S., & Haverkamp, W. (2009). Grenzen und Möglichkeiten der invasiven Risikostratifikation : Brauchen wir die programmierte Elektrostimulation noch? [Limits and scopes of invasive risk stratification. Do we still need programmed ventricular stimulation?]. Herz, 34(7), 528-38. https://doi.org/10.1007/s00059-009-3294-6
Rolf, Sascha, and Haverkamp, Wilhelm. "Grenzen und Möglichkeiten der invasiven Risikostratifikation : Brauchen wir die programmierte Elektrostimulation noch?" [Limits and scopes of invasive risk stratification. Do we still need programmed ventricular stimulation?]. Herz vol. 34,7 (2009): 528-38. doi: https://doi.org/10.1007/s00059-009-3294-6
Rolf S, Haverkamp W. Grenzen und Möglichkeiten der invasiven Risikostratifikation : Brauchen wir die programmierte Elektrostimulation noch? [Limits and scopes of invasive risk stratification. Do we still need programmed ventricular stimulation?]. Herz. 2009 Nov;34(7):528-38. doi: 10.1007/s00059-009-3294-6. German. PMID: 20091252.
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Herz. 2009 Nov;34(7):528-38. doi: 10.1007/s00059-009-3294-6.

[Limits and scopes of invasive risk stratification. Do we still need programmed ventricular stimulation?].

Herz

[Article in German]
Sascha Rolf, Wilhelm Haverkamp

Affiliations

  1. Medizinische Klinik mit Schwerpunkt Kardiologie, Charité - Campus Virchow-Klinikum, Berlin, Germany. [email protected]

PMID: 20091252 DOI: 10.1007/s00059-009-3294-6

Abstract

Patients with ischemic heart disease and left ventricular systolic dysfunction (ICM), dilated (DCM), hypertrophic (HCM), or arrhythmogenic right ventricular cardiomyopathy (ARVCM) carry a high risk of sudden cardiac death (SCD). Ventricular tachyarrhythmias are most often the cause of SCD, which can be treated with internal cardioverter defibrillators (ICDs). However, a great proportion of these high-risk patients will never experience potentially lethal ventricular arrhythmias, and as such will never be in need of these devices. Given the risks, inconvenience, and costs of ICDs, markers that adequately stratify patients according to their risk of SCD are needed. Programmed ventricular stimulation (PVS) has long been used to identify the patients' risk of SCD. However, the prognostic ability of PVS is only modest and the negative predictive value is poor. As far as patients with ICM are concerned, recent data from the MUSTT and MADIT II trials demonstrate that in patients with a left ventricular ejection fraction between 30% and 40%, inducibility by PVS can help to identify patients who are at particularly increased risk of SCD. The value of PVS in patients with DCM, HCM, and ARVCM for risk stratification of SCD is less clear and the available data even more limited. In these patients, the inducibility of ventricular tachyarrhythmias does not clearly correlate with VT/VF (ventricular tachycardia/ventricular fibrillation) risk, and more importantly, noninducibility does not portend good prognosis. The current German guidelines appreciate these uncertainties of PVS for risk stratification with class IIb recommendations in certain patients with ICM, HCM or ARVCM. In the future, combining the results of invasive PVS with other noninvasive parameters may improve its prognostic value. Furthermore, expanding the role of PVS to guiding therapeutic ablation of ventricular arrhythmias may influence patient's future risk of SCD.

References

  1. JAMA. 1999 Dec 22-29;282(24):2302-3 - PubMed
  2. Eur Heart J. 2008 Jul;29(13):1653-61 - PubMed
  3. J Am Coll Cardiol. 1997 Nov 15;30(6):1500-5 - PubMed
  4. Pacing Clin Electrophysiol. 1997 Oct;20(10 Pt 2):2714-8 - PubMed
  5. Eur Heart J. 1988 Feb;9(2):177-85 - PubMed
  6. N Engl J Med. 2002 Mar 21;346(12):877-83 - PubMed
  7. Pacing Clin Electrophysiol. 2009 Jun;32(6):755-61 - PubMed
  8. Am Heart J. 1989 Feb;117(2):342-7 - PubMed
  9. N Engl J Med. 1994 Dec 8;331(23):1564-75 - PubMed
  10. Circulation. 2002 Nov 5;106(19):2466-72 - PubMed
  11. Circulation. 1991 Mar;83(3):756-63 - PubMed
  12. Clin Res Cardiol. 2006 Dec;95(12):696-708 - PubMed
  13. Pacing Clin Electrophysiol. 1988 May;11(5):562-8 - PubMed
  14. J Am Coll Cardiol. 1991 Sep;18(3):780-8 - PubMed
  15. Herz. 1985 Jun;10(3):134-7 - PubMed
  16. N Engl J Med. 2000 Feb 10;342(6):365-73 - PubMed
  17. Int J Cardiol. 2006 Mar 8;107(3):360-8 - PubMed
  18. N Engl J Med. 2000 Jun 29;342(26):1937-45 - PubMed
  19. Am J Cardiol. 1980 Apr;45(4):725-31 - PubMed
  20. Circulation. 1997 Sep 16;96(6):1888-92 - PubMed
  21. Circulation. 2004 Mar 30;109(12):1503-8 - PubMed
  22. N Engl J Med. 1978 Oct 5;299(14):729-34 - PubMed
  23. N Engl J Med. 1996 Dec 26;335(26):1933-40 - PubMed
  24. Eur Heart J. 1994 Jan;15(1):134-7 - PubMed
  25. Am Heart J. 1986 Sep;112(3):505-8 - PubMed
  26. Europace. 2009 Mar;11(3):289-96 - PubMed
  27. J Am Coll Cardiol. 2000 Dec;36(7):2212-8 - PubMed
  28. Circulation. 2002 Jul 9;106(2):233-8 - PubMed
  29. Circulation. 2004 Oct 5;110(14):1879-84 - PubMed
  30. Herz. 2009 Jun;34(4):290-7 - PubMed
  31. JAMA. 2004 Dec 15;292(23):2874-9 - PubMed
  32. Am J Cardiol. 1983 Jan 1;51(1):75-80 - PubMed
  33. Am J Cardiol. 1990 Jan 1;65(1):49-52 - PubMed
  34. Circulation. 1984 Jul;70(1):52-7 - PubMed
  35. J Am Coll Cardiol. 2006 Jan 3;47(1):98-107 - PubMed
  36. N Engl J Med. 1988 May 12;318(19):1255-7 - PubMed
  37. Am J Cardiol. 1986 Nov 1;58(10):998-1000 - PubMed
  38. J Am Coll Cardiol. 1994 Mar 1;23(3):586-90 - PubMed
  39. Int J Cardiol. 1999 Dec 1;71(3):243-50 - PubMed
  40. Circulation. 1984 Sep;70(3):451-6 - PubMed
  41. Am Heart J. 1991 Apr;121(4 Pt 1):1124-31 - PubMed
  42. J Am Coll Cardiol. 1985 Nov;6(5):1174-7 - PubMed
  43. Pacing Clin Electrophysiol. 2001 Nov;24(11):1623-30 - PubMed
  44. J Am Coll Cardiol. 1986 Mar;7(3):701-4 - PubMed
  45. J Am Coll Cardiol. 2003 May 21;41(10):1707-12 - PubMed
  46. N Engl J Med. 1999 Dec 16;341(25):1882-90 - PubMed
  47. Am J Cardiol. 1985 Aug 1;56(4):337-41 - PubMed
  48. Prog Cardiovasc Dis. 2008 Sep-Oct;51(2):97-105 - PubMed
  49. Circulation. 1990 Aug;82(2):350-8 - PubMed
  50. N Engl J Med. 2007 Dec 27;357(26):2657-65 - PubMed
  51. Circulation. 2003 Dec 23;108(25):3084-91 - PubMed
  52. N Engl J Med. 2005 Jan 20;352(3):225-37 - PubMed
  53. J Cardiovasc Electrophysiol. 2000 Jan;11(1):11-7 - PubMed
  54. Lancet. 2009 Apr 11;373(9671):1289-300 - PubMed
  55. Am J Cardiol. 1983 Nov 1;52(8):969-74 - PubMed
  56. Circulation. 2001 Jun 26;103(25):3075-80 - PubMed
  57. Ann Intern Med. 1997 Apr 1;126(7):561-82 - PubMed
  58. N Engl J Med. 2004 May 20;350(21):2140-50 - PubMed
  59. Circulation. 2002 Mar 26;105(12):1453-8 - PubMed
  60. J Am Coll Cardiol. 2009 Feb 10;53(6):471-9 - PubMed
  61. Herz. 2005 Mar;30(2):91-101 - PubMed
  62. Circulation. 1985 Jul;72(1):1-7 - PubMed
  63. Circulation. 1987 Jun;75(6):1178-85 - PubMed
  64. Br Heart J. 1980 Mar;43(3):245-51 - PubMed
  65. Circulation. 1992 Sep;86(3):730-40 - PubMed
  66. J Cardiovasc Electrophysiol. 2004 Feb;15(2):170-6 - PubMed
  67. J Am Coll Cardiol. 2001 Jun 1;37(7):1901-7 - PubMed
  68. N Engl J Med. 1989 Aug 10;321(6):406-12 - PubMed
  69. Circulation. 1986 Apr;73(4):645-52 - PubMed
  70. Herz. 2005 Sep;30(6):565-70 - PubMed
  71. Ann Intern Med. 1993 Dec 15;119(12):1187-97 - PubMed
  72. Circulation. 1989 Nov;80(5):1489-92 - PubMed
  73. Circulation. 2001 Oct 30;104(18):2158-63 - PubMed
  74. J Am Coll Cardiol. 1998 Sep;32(3):739-45 - PubMed
  75. J Am Coll Cardiol. 2004 May 19;43(10):1843-52 - PubMed
  76. N Engl J Med. 2004 May 20;350(21):2151-8 - PubMed
  77. N Engl J Med. 1997 Mar 13;336(11):775-85 - PubMed
  78. Chest. 1988 Jan;93(1):85-90 - PubMed
  79. Am J Cardiol. 1979 Jul;44(1):1-8 - PubMed
  80. Am J Cardiol. 1986 Nov 1;58(10):992-7 - PubMed
  81. Clin Res Cardiol. 2007 Sep;96(9):634-51 - PubMed

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