Sinus Mapping in Patients with Cardiac Arrest and Coronary Disease—Results and Correlation with Outcome

ALAN H. KADISH, MARK E. ROSENTHAL, JOSEPH A. VASSALLO, DENNIS M. CASSIDY, ALFRED E. BUXTON, FRANCIS E. MARCHLINSKI, JOHN M. MILLER, MARK E. JOSEPHSON

Research output: Contribution to journalArticle

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Abstract

Electrophysiological testing and left ventricular endocardial mapping in sinus rhythm were performed in 61 patients with coronary artery disease who presented with cardiac arrest in an attempt to relate the results of these studies to clinical outcome. Forty‐one patients (67%) had inducible sustained arrhythmias (18 uniform ventricular tachycardia, 23 polymorphic ventricular tachycardia/ventricular fibrillation) and 20 had no inducible arrhythmia. Patients with inducible arrhythmia had 45% abnormal and 6% fractionated electrograms versus 33% and 0% for those without inducible arrhythmia (P > 0.05 for both comparisons). Sixteen of 59 patients (27%) with adequate follow‐up had arrhythmia recurrence (11/39 [31%] with inducible arrhythmia and 5/20 [25%] without inducible arrhythmia) over a mean follow‐up period of 27 months. Of five patients without inducible arrhythmia who experienced recurrence, two did so despite the anti‐ischemic therapy. In the 20 patients without inducible arrhythmia, the 15 who remained arrhythmia‐free had a mean of 78 ± 22% normal sites versus 46 ± 24% normal sites in those with recurrence (P > 0.05). We conclude that in patients with coronary artery disease and cardiac arrest: 1) patients without inducible arrhythmia have less marked endocardial electrical abnormality than those with inducible arrhythmia, 2) those patients who have marked endocardial abnormality despite the lack of inducible arrhythmia are at risk for clinical recurrence which suggests that these abnormalities may represent an anatomic substrate for arrhythmia which cannot be identified by programmed stimulation, These patients are candidates for AICD implantation and 3) patients with relatively normal endocardial electrograms do well with anti‐ischemic therapy alone. (PACE, Vol. 12 February 1989)

Original languageEnglish (US)
Pages (from-to)301-310
Number of pages10
JournalPacing and Clinical Electrophysiology
Volume12
Issue number2
DOIs
StatePublished - Feb 1989

Fingerprint

Artificial Cardiac Pacing
Cardiac Catheterization
Heart Arrest
Electric Stimulation
Coronary Disease
Cardiac Arrhythmias
Heart Diseases
Electrocardiography
Differential Diagnosis
Recurrence
Ventricular Tachycardia
Coronary Artery Disease

Keywords

  • cardiac arrest
  • electrophysiological studies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

KADISH, ALAN. H., ROSENTHAL, MARK. E., VASSALLO, JOSEPH. A., CASSIDY, DENNIS. M., BUXTON, ALFRED. E., MARCHLINSKI, FRANCIS. E., ... JOSEPHSON, MARK. E. (1989). Sinus Mapping in Patients with Cardiac Arrest and Coronary Disease—Results and Correlation with Outcome. Pacing and Clinical Electrophysiology, 12(2), 301-310. https://doi.org/10.1111/j.1540-8159.1989.tb02663.x

Sinus Mapping in Patients with Cardiac Arrest and Coronary Disease—Results and Correlation with Outcome. / KADISH, ALAN H.; ROSENTHAL, MARK E.; VASSALLO, JOSEPH A.; CASSIDY, DENNIS M.; BUXTON, ALFRED E.; MARCHLINSKI, FRANCIS E.; MILLER, JOHN M.; JOSEPHSON, MARK E.

In: Pacing and Clinical Electrophysiology, Vol. 12, No. 2, 02.1989, p. 301-310.

Research output: Contribution to journalArticle

KADISH, ALANH, ROSENTHAL, MARKE, VASSALLO, JOSEPHA, CASSIDY, DENNISM, BUXTON, ALFREDE, MARCHLINSKI, FRANCISE, MILLER, JOHNM & JOSEPHSON, MARKE 1989, 'Sinus Mapping in Patients with Cardiac Arrest and Coronary Disease—Results and Correlation with Outcome', Pacing and Clinical Electrophysiology, vol. 12, no. 2, pp. 301-310. https://doi.org/10.1111/j.1540-8159.1989.tb02663.x
KADISH ALANH, ROSENTHAL MARKE, VASSALLO JOSEPHA, CASSIDY DENNISM, BUXTON ALFREDE, MARCHLINSKI FRANCISE et al. Sinus Mapping in Patients with Cardiac Arrest and Coronary Disease—Results and Correlation with Outcome. Pacing and Clinical Electrophysiology. 1989 Feb;12(2):301-310. https://doi.org/10.1111/j.1540-8159.1989.tb02663.x
KADISH, ALAN H. ; ROSENTHAL, MARK E. ; VASSALLO, JOSEPH A. ; CASSIDY, DENNIS M. ; BUXTON, ALFRED E. ; MARCHLINSKI, FRANCIS E. ; MILLER, JOHN M. ; JOSEPHSON, MARK E. / Sinus Mapping in Patients with Cardiac Arrest and Coronary Disease—Results and Correlation with Outcome. In: Pacing and Clinical Electrophysiology. 1989 ; Vol. 12, No. 2. pp. 301-310.
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abstract = "Electrophysiological testing and left ventricular endocardial mapping in sinus rhythm were performed in 61 patients with coronary artery disease who presented with cardiac arrest in an attempt to relate the results of these studies to clinical outcome. Forty‐one patients (67{\%}) had inducible sustained arrhythmias (18 uniform ventricular tachycardia, 23 polymorphic ventricular tachycardia/ventricular fibrillation) and 20 had no inducible arrhythmia. Patients with inducible arrhythmia had 45{\%} abnormal and 6{\%} fractionated electrograms versus 33{\%} and 0{\%} for those without inducible arrhythmia (P > 0.05 for both comparisons). Sixteen of 59 patients (27{\%}) with adequate follow‐up had arrhythmia recurrence (11/39 [31{\%}] with inducible arrhythmia and 5/20 [25{\%}] without inducible arrhythmia) over a mean follow‐up period of 27 months. Of five patients without inducible arrhythmia who experienced recurrence, two did so despite the anti‐ischemic therapy. In the 20 patients without inducible arrhythmia, the 15 who remained arrhythmia‐free had a mean of 78 ± 22{\%} normal sites versus 46 ± 24{\%} normal sites in those with recurrence (P > 0.05). We conclude that in patients with coronary artery disease and cardiac arrest: 1) patients without inducible arrhythmia have less marked endocardial electrical abnormality than those with inducible arrhythmia, 2) those patients who have marked endocardial abnormality despite the lack of inducible arrhythmia are at risk for clinical recurrence which suggests that these abnormalities may represent an anatomic substrate for arrhythmia which cannot be identified by programmed stimulation, These patients are candidates for AICD implantation and 3) patients with relatively normal endocardial electrograms do well with anti‐ischemic therapy alone. (PACE, Vol. 12 February 1989)",
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