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Stratification of sudden death risk in patients receiving long-term amiodarone treatment for sustained ventricular tachycardia or ventricular fibrillation



Stratification of sudden death risk in patients receiving long-term amiodarone treatment for sustained ventricular tachycardia or ventricular fibrillation



American Journal of Cardiology 71(10): 823-826



One hundred twenty-two patients treated chronically with amiodarone for sustained ventricular tachycardia or ventricular fibrillation after failing conventional antiarrhythmic therapy were analyzed to determine which factors were predictive of sudden cardiac death during follow-up. The mean left ventricular ejection fraction in the study group was 0.32, and 87% of the patients had coronary artery disease with a prior myocardial infarction. During a median follow-up of 19.5 months, 30 patients died suddenly. The only variable that was predictive of sudden death was left ventricular ejection fraction. Twenty-nine of the 84 patients with ejection fractions lt 0.40 died suddenly, compared with 1 of 35 patients with ejection fraction gtoreq 0.40. The actuarial probability of sudden death at 5 years was 49% when the ejection fraction was lt 0.40, and 5% when the ejection fraction was gtoreq 0.40 (p = 0.0004). These results indicate that patients treated with amiodarone for sustained ventricular tachycardia or ventricular fibrillation whose ejection fractions are gtoreq 0.40 are at low risk for sudden death. Patients with ejection fractions lt 0.40 remain at high risk for sudden death, and should be considered for additional or alternative therapy.

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Accession: 009461349

Download citation: RISBibTeXText

PMID: 8456761

DOI: 10.1016/0002-9149(93)90831-v



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