Incidence, Determinants, and Prognostic Implications of True Pleomorphism of Ventricular Tachycardia in Patients With Implantable Cardioverter-Defribillators: A Substudy of the DATAS Trial

BACKGROUND—The occurrence of monomorphic ventricular tachycardia (M-VT) with >1 QRS morphology during the same episode (pleomorphism [PL]) or in different episodes (multiple morphologies [MM]) has been described through ECG. Implantable cardioverter-defribillator (ICD) electrograms (EGs) provide...

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Veröffentlicht in:Circulation. Arrhythmia and electrophysiology 2011-02, Vol.4 (1), p.33-42
Hauptverfasser: Hadid, Claudio, Almendral, Jesus, Ortiz, Mercedes, Schwab, Joerg Otto, Janko, Sabine, Mischke, Karl, Arribas, Fernando, Wolpert, Christian, Ricci, Renato, Adragao, Pedro, Cobo, Erik, Navarro, Xavier, Quesada, Aurelio
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Sprache:eng
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Zusammenfassung:BACKGROUND—The occurrence of monomorphic ventricular tachycardia (M-VT) with >1 QRS morphology during the same episode (pleomorphism [PL]) or in different episodes (multiple morphologies [MM]) has been described through ECG. Implantable cardioverter-defribillator (ICD) electrograms (EGs) provide the opportunity to analyze virtually all spontaneous M-VT episodes. We sought to study the incidence, determinants, and prognostic significance of PL and MM as assessed by ICD-EG in a prospective series of patients with ICDs. METHODS AND RESULTS—Spontaneous episodes of M-VT were analyzed before ICD intervention. PL was defined as >1 ICD-EG morphology, each having ≥6 consecutive identical beats during the same VT episode, and MM as >1 ICD-EG morphology in different M-VT episodes in the same patient. We analyzed 1881 M-VT episodes from 315 patients followed for 17 months. PL and MM occurred in 6% and 19%, respectively, of the total population (16% and 62% of patients with M-VT). Recurrent M-VT as diagnosis for ICD indication predicted PL and MM. Patients with PL more frequently developed MM (85% versus 15%; P
ISSN:1941-3149
1941-3084
DOI:10.1161/CIRCEP.110.957068