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Outcome of men with ischemic cardiomyopathy, asymptomatic nonsustained ventricular tachycardia, and negative electrophysiologic studies

      The prognosis of patients with ischemic cardiomyopathy and asymptomatic nonsustained ventricular tachycardia (VT) is generally considered benign for arrhythmic events following a negative electrophysiologic study (EPS).
      • Buxton A.E.
      • Marchlinski F.E.
      • Flores B.T.
      • Miller J.M.
      • Doherty J.U.
      • Josephson M.E.
      Nonsustained ventricular tachycardia in patients with coronary artery disease role of electrophysiologic study.
      ,
      • Wilber D.J.
      • Olshansky B.
      • Moran J.F.
      • Scanlon P.J.
      Electrophysiological testing and nonsustained ventricular tachycardia use and limitations in patients with coronary artery disease and impaired ventricular function.
      ,
      • Kadish A.
      • Schmaltz S.
      • Calkins H.
      • Morady F.
      Management of nonsustained ventricular tachycardia guided by electrophysiological testing.
      Other studies have produced conflicting data, suggesting that a negative EPS is not necessarily indicative of a good outcome in these types of patients.
      • Hammill S.C.
      • Trusty J.M.
      • Wood D.J.
      • Bailey K.R.
      • Vatterott P.J.
      • Osborn M.J.
      • Holmes D.R.
      • Gersh B.J.
      Influence of ventricular function and presence or absence of coronary artery disease on results of electrophysiologic testing for asymptomatic nonsustained ventricular tachycardia.
      ,
      • Hernandez M.
      • Taylor J.
      • Marinchak R.
      • Rials S.
      • Rubin A.
      • Kowey P.
      Outcome of patients with nonsustained ventricular tachycardia and severely impaired ventricular function who have negative electrophysiologic studies.
      ,
      • Kowey P.R.
      • Waxman H.L.
      • Greenspon A.
      • Greenberg R.
      • Poll D.
      • Kutalek S.
      • Gessman L.
      • Muenz L.
      Value of electrophysiologic testing in patients with previous myocardial infarction and nonsustained ventricular tachycardia.
      Furthermore, these studies cast doubt as to the clinical utility of a negative EPS because it did not have independent prognostic value in determining arrhythmic events.
      • Hammill S.C.
      • Trusty J.M.
      • Wood D.J.
      • Bailey K.R.
      • Vatterott P.J.
      • Osborn M.J.
      • Holmes D.R.
      • Gersh B.J.
      Influence of ventricular function and presence or absence of coronary artery disease on results of electrophysiologic testing for asymptomatic nonsustained ventricular tachycardia.
      ,
      • Kowey P.R.
      • Waxman H.L.
      • Greenspon A.
      • Greenberg R.
      • Poll D.
      • Kutalek S.
      • Gessman L.
      • Muenz L.
      Value of electrophysiologic testing in patients with previous myocardial infarction and nonsustained ventricular tachycardia.
      We sought to assess the natural history of patients potentially at high risk for sudden cardiac death who have ischemic cardiomyopathy and asymptomatic nonsustained VT, who underwent an EPS for the purpose of risk stratification for arrhythmic death, and who were subsequently deemed at low risk for sudden arrhythmic death after a negative EPS.
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