Nonsustained Ventricular Tachycardia in Coronary Artery Disease: Relation to Inducible Sustained Ventricular Tachycardia

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

“…In a MUSTT trial substudy, the ECG characteristics of NSVT (rate, duration, frequency, occurrence in-hospital vs. out-of-hospital) did not correlate with inducibility (193)(194)(195). Survival was worse for in-hospital compared with out-of-hospital NSVT, (193) suggesting that different risk stratification criteria may be necessary in asymptomatic ambulatory patients.…”

Prediction of Sustained Ventricular Tachycardia Inducible by Programmed Stimulation in Patients With Coronary Artery Disease

“…8 The median duration and cycle length of spontaneous nonsustained ventricular tachycardia were 5 complexes and 420 ms, respectively. 6 The protocol for electrophysiological studies, standardized at all participating centers, included delivery of 1, 2, and 3 ventricular extrastimuli at 2 right ventricular sites at pacing cycle lengths of 600 and 400 ms and bursts of 5 to 15 ventricular stimuli at cycle lengths of 350 to 250 ms. The end point was the induction of sustained (duration Ն30 seconds) ventricular tachycardia or fibrillation or completion of the protocol.…”

“…We have demonstrated previously that ECG characteristics of spontaneous nonsustained ventricular tachycardia have no relation to inducibility of sustained ventricular tachycardia. 6,7 The purpose of the present analysis was to identify clinical factors that might predict patients with coronary artery disease having sustained ventricular tachycardia inducible by programmed stimulation.…”

Effect of Programmed Number of Intervals to Detect Ventricular Fibrillation on Implantable Cardioverter‐Defibrillator Aborted and Unnecessary Shocks

“…Holter data regarding the durations of nonsustained VT in potential ICD patients indicate that increasing NID to a value greater than 18 would benefit only a small fraction of patients. A median 7 beats (13‐beat 75 percentile) was the longest documented nonsustained VT in 1,480 patients from the MUSTT study 16 . While the results of our study apply directly to the specific ICD detection algorithm studied, the number of intervals or duration for detection of VF is programmable in all ICDs, and all ICD manufacturers have settings comparable to NID 18.…”

“…A median 7 beats (13-beat 75 percentile) was the longest documented nonsustained VT in 1,480 patients from the MUSTT study. 16 While the results of our study apply directly to the specific ICD detection algorithm studied, the number of intervals or duration for detection of VF is programmable in all ICDs, and all ICD manufacturers have settings comparable to NID 18. Further reduction of detected and treated nonsustained VT may be achieved with longer VF detection durations (e.g., 24/32, 30/40), which are under evaluation in a prospective randomized study.…”