抄録
Background The therapeutic strategy for non-sustained ventricular tachycardia (NSVT), considered as a risk-stratifier for sudden cardiac death (SCD), still remains undetermined. Methods and Results In the present study 222 of 4,079 patients (5.4%) hospitalized with NSVT during 2002 to 2004 were prospectively evaluated using an algorithm for risk-stratification according to each type of structural heart disease. The algorithm comprises the left ventricular ejection fraction, signal-averaged electrocardiography, programmed ventricular stimulation and the family history of SCD. Of the 222 patients, 151 (68.0%) were successfully risk-stratified and 32 patients consequently received an implantable cardioverter defibrillator (ICD) (21.2%; algorithm-ICD group). The remaining 119 patients without an ICD (algorithm-observation group) were observed. During 27.7±11.4 months of follow-up, the patients in the algorithm-ICD group had a significantly higher prevalence of tachyarrhythmic events than did those in the algorithm-observation group (9/32 vs 1/119; p<0.05). In the algorithm-ICD group, 2, 1 and 6 patients experienced an SCD, aborted SCD and appropriate ICD intervention, respectively, while there was only 1 SCD in the algorithm-observation group. Conclusions The proposed algorithm for risk-stratification of patients with NSVT may be feasible for appropriate selection of high-risk patients and candidates for prophylactic ICD implantation. (Circ J 2007; 71: 1107 - 1114)
