RESUMO
INTRODUCTION: The benefit of implantable cardioverter defibrillator (ICD) therapy in patients with haemodynamically stable ventricular tachycardia (VT) is not well documented. METHODS: In this single-centre observational study, we examined the medical records of 53 patients (48 men, mean age 66 +/- 1 years) treated with an ICD. The patients were classified into four groups with comparable clinical and electrophysiological characteristics, as follows: patients presenting with (a) stable VT, (b) unstable VT, (c) cardiac arrest, and (d) non-sustained VT and induced sustained VT or ventricular fibrillation (VF) on electrophysiological study. Kaplan-Meier event-free survival curves were constructed and the incidence of appropriate device therapy was compared among the four groups. RESULTS: All patients had structural heart disease with a mean ejection fraction of 32.5 +/- 1.3%. During a mean follow-up period of 35.5 +/- 2.7 months, event-free survival was similar in the four groups. However, appropriate device therapy occurred in 9 (81.8%) patients with stable VT, in 6 (44.4%) patients with unstable VT, in 2 (33.3%) patients with cardiac arrest and in 6 (33.3%) patients with non-sustained VT and induced sustained VT/VF. Compared to the total patient cohort, appropriate therapy was significantly (p = 0.024) more common in patients presenting with stable monomorphic VT. In 2 (22.2%) of these patients, the tachycardia rate was faster than the presenting VT. CONCLUSIONS: High recurrence rates are observed in patients with structural heart disease and stable VT, with a considerable proportion being faster than the presenting VT. ICD therapy is beneficial and should be offered in these patients.
