Very Fast Ventricular Tachycardia. Background: The long-term outcomes of patients with inducible very fast ventricular tachycardia (VFVT) of cycle length (CL) 200 to 250 ms have not been well studied.
Methods: Consecutive patients with ischemic cardiomyopathy with a left ventricular ejection fraction (LVEF) of ≤40% (n = 300) underwent programmed ventricular stimulation (PVS) and were divided into 4 groups based on results of the study. Group A were noninducible, had induced ventricular fibrillation (VF), or polymorphic VT (CL < 200 ms); group B had inducible VFVT (200–250 ms); group C had inducible fast ventricular tachycardia (FVT; CL 251–320 ms); and group D had inducible slow VT (CL >320 ms). The primary endpoint was spontaneous ventricular arrhythmia or sudden death.
Results: The mean age was 63 ± 12 years and mean LVEF was 29 ± 7%. At mean follow-up of 38 ± 25 months (median 30 months), the primary endpoint rate was 6.6%, 34%, 44%, and 71% in groups A, B C, and D, respectively (P < 0.001). Neither mode of induction of VT nor LVEF altered the observed pattern in the primary endpoint. There was no significant difference in the primary endpoint among implanted cardioverter defibrillator recipients in groups B and C (38% vs 45%, P = 0.43). Adjusted hazard ratios for the primary endpoint compared to group A were 3.2, 3.5, and 7.0 in groups B, C, and D, respectively (P < 0.05).
Conclusions: Inducible VFVT (200–250 ms) is a clinically significant arrhythmia with adverse long-term outcomes and should not be considered a nonspecific finding of PVS. (J Cardiovasc Electrophysiol, Vol. 21, pp. 262–269, March 2010)