Scar extent as a predictive factor of ventricular tachycardia cycle length after myocardial infarction: implications for implantable cardioverter-defibrillator programming optimization

• DOI: 10.1093/europace/eut289
• Publication Date: 2013-11-02T00:59:28Z
• Authors: J. Alexandre; E. Saloux; A. Lebon; A. E. Dugue; A. Lemaitre; V. Roule; F. Labombarda; L. Champ-Rigot; S. Gomes; A. Pellissier; P. Scanu; P. Milliez
• Keywords: Univariate analysis

After an old myocardial infarction (MI), patients are at risk for reentrant ventricular tachycardia (VT) due to scar tissue that can be accurately identified by late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Although the ability of LGE-CMR predict sustained VT in implantable cardioverter-defibrillator (ICD) recipients has been well established, its use monomorphic (sustained or not) cycle length (CL) and so, optimize ICD programming never investigated. We included retrospectively 49 consecutive with MI who had undergone before implantation over a 4-year period (2006–09). Patients amiodarone used were excluded. Scar extent was assessed measuring mass, percent scar, transmural extent. The endpoint occurrence VT, requiring therapy not. occurred 26 patients. median follow-up duration 31 months. parameters significantly correlated study endpoint. With univariate regression analysis, mass highest correlation CL (R = 0.671, P 0.0002). Receiver-operating characteristic curve showed (area under 0.977, < 0.0001). For cut-off value 17.6 g, there is 100% specificity 94.4% sensitivity. In this observational retrospective study, studied specific sensitive so could promising option improve post-implantation decrease appropriate inappropriate shocks. These conclusions must now confirmed large prospective study.