Non-sustained Ventricular Tachycardia: Is It Possible to Identify the High-Risk Patients and How to Treat Them?

  • G. Turitto
Conference paper


Identification of patients at high risk for sudden cardiac death, among those presenting with complex ventricular arrhythmias and spontaneous nonsustained ventricular tachycardia (NS-VT), is of paramount importance. This chapter reviews the role of risk stratification techniques, with particular emphasis on the signal-averaged electrocardiogram (ECG) and programmed ventricular stimulation (PVS), in the management of patients with NS-VT.


Sudden Death Antiarrhythmic Therapy Sustained Ventricular Tachycardia Nonsustained Ventricular Tachycardia Organic Heart Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bigger JT Jr, Fleiss JL, Kleiger R, Miller JP, Rolnitzky LM, the Multicenter Post-Infarction Research Group (1984) The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation 69: 250PubMedCrossRefGoogle Scholar
  2. 2.
    Mukharji J, Rude E, Poole WK et al (1984) Risk factors for sudden death after acute myocardial infarction: two-year follow-up. Am J Cardiol 54: 31PubMedCrossRefGoogle Scholar
  3. 3.
    Maisel AS, Scott N, Gilpin E et al (1985) Complex ventricular arrhythmias in patients with Q wave versus non-Q wave myocardial infarction. Circulation 72: 963PubMedCrossRefGoogle Scholar
  4. 4.
    Bigger JT Jr, Weld FM, Rolnitzky LM (1981) Prevalence, characteristics and significance of ventricular tachycardia (three or more complexes) detected with ambulatory electrocardiographic recording in the late phase of acute myocardial infarction. Am J Cardiol 48: 815PubMedCrossRefGoogle Scholar
  5. 5.
    Yusuf S, Venkatesh G, Teo KK (1993) Critical review of the approaches to the prevention of sudden death. Am J Cardiol 72: 51FGoogle Scholar
  6. 6.
    Cardiac Arrhythmia Suppression Trial (CAST) (1989) Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 321: 406CrossRefGoogle Scholar
  7. 7.
    Echt DS, Liebson PR, Mitchell LB et al (1991) Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. N Engl J Med 324: 781Google Scholar
  8. 8.
    Cardiac Arrhythmia Suppression Trial II (1992) Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. N Engl J Med 327: 227CrossRefGoogle Scholar
  9. 9.
    Burkart F, Pfisterer M, Kiowski W, Follath F, Burckhardt D (1990) Effect of antiarrhythmic therapy on mortality in survivors of myocardial infarction with asymptomatic complex ventricular arrhythmias: Basel antiarrhythmic study of infarct survival ( BASIS ). J Am Coll Cardin]. 16: 1711Google Scholar
  10. 10.
    Ceremuzynski L, Kleczar E, Krzeminska-Pakula M et al (1992) The effect of amiodarone on mortality after myocardial infarction: a double-blind, placebo controlled, pilot study. J Am Coll Cardiol 20: 1056PubMedCrossRefGoogle Scholar
  11. 11.
    Larsen L, Markham J, Haffajee CL (1993) Sudden death in idiopathic dilated cardiomyopathy: role of ventricular arrhythmias. PACE 16: 1051PubMedCrossRefGoogle Scholar
  12. 12.
    Tamburro P, Wilber D (1992) Sudden death in idiopathic dilated cardiomyopathy. Am Heart J 124: 1035PubMedCrossRefGoogle Scholar
  13. 13.
    El-Sherif N, Turitto G (1995) Ventricular premature complex: risk stratification and management. In: Mandel WJ (ed) Cardiac arrhyhthmias. Their mechanisms, diagnosis and management. Lippincott, Philadelphia, pp 605–625Google Scholar
  14. 14.
    Turitto G, Fontaine JM, Ursell SN, Caref EB, Henkin R, ElSherif N (1988) Value of the signal-averaged electrocardiogram as a predictor of the results of programmed stimulation in non-sustained ventricular tachycardia. Am J Cardiol 61: 1272PubMedCrossRefGoogle Scholar
  15. 15.
    Wiener L, Stevenson W, Weiss J, Nademanee K (1990) Are electrophysiologic studies indicated in nonsustained ventricular tachycardia? Am J Cardiol 66: 642PubMedCrossRefGoogle Scholar
  16. 16.
    Kowey PR, Taylor JE, Marinchak RA, Rials SJ (1992) Does programmed stimulation really help in the evaluation of patients with nonsustained ventricular tachycardia? Results of a meta-analysis. Am Heart J 123: 481PubMedCrossRefGoogle Scholar
  17. 17.
    Kadish A, Schmaltz S, Calkins H, Morady F (1993) Management of nonsustained ventricular tachycardia guided by electrophysiological testing. PACE 16: 1037PubMedCrossRefGoogle Scholar
  18. 18.
    Pires LA, Huang SKS (1993) Nonsustained ventricular tachycardia: identification and management of high-risk patients. Am Heart J 126: 189PubMedCrossRefGoogle Scholar
  19. 19.
    Buxton AE, Fisher JD, Josephson ME et al (1993) Prevention of sudden death in patients with coronary artery disease: the multicenter unsustained tachycardia trial ( MUSTT ). Prog Cardiovasc Dis 36: 215Google Scholar
  20. 20.
    Turitto G, Fontaine JM, Ursell S, Caref EB, Bekheit S, ElSherif N (1990) Risk stratification and management of patients with organic heart disease and non-sustained ventricular tachycardia: role of programmed stimulation, left ventricular ejection fraction and the signal averaged electrocardiogram. Am J Med 88 (1): 35NPubMedGoogle Scholar
  21. 21.
    Wilber DJ, Olshansky B, Moran JF, Scanlon PJ (1990) Electrophysiological testing and nonsustained ventricular tachycardia: use and limitations in patients with coronary artery disease and impaired left ventricular function. Circulation 82: 350PubMedCrossRefGoogle Scholar
  22. 22.
    Buxton AE, Marchlinski FE, Waxman HL, Flores BT, Cassidy DM, Josephson ME (1984) Prognostic factors in nonsustained ventricular tachycardia. Am J Cardiol 53: 1275PubMedCrossRefGoogle Scholar
  23. 23.
    Buxton AE, Marchlinski FE, Waxman HL et al (1987) Non-sustained ventricular tachycardia in patients with coronary artery disease: role of electrophysiology study. Circulation 75: 1178PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 1996

Authors and Affiliations

  • G. Turitto
    • 1
  1. 1.Cardiac Electrophysiology SectionState University of New York, Health Science Center at BrooklynBrooklynUSA

Personalised recommendations