Ventricular tachycardia during exercise testing as a predictor of sudden death in patients with chronic chagasic cardiomyopathy and ventricular arrhythmias.

A. A. de Paola, J. A. Gomes, A. B. Terzian, M. H. Miyamoto, E. E. Martinez Fo

Division of Clinical Cardiac Electrophysiology, São Paulo Federal University, Escola Paulista de Medicina, Brazil.

OBJECTIVE--To verify the prognostic value of exercise induced ventricular arrhythmias in patients with chagasic cardiomyopathy. METHODS--69 consecutive patients (37 male, 32 female; age range 21-67 years) with chronic chagasic cardiomyopathy and ventricular arrhythmias (more than 10 ventricular premature complexes per hour) were evaluated during treadmill exercise testing, using the Bruce protocol. Protocol end points were peak heart rate or presence of sustained ventricular tachycardia. MAIN OUTCOME MEASURE--Sudden cardiac death. RESULTS--44 patients (group I) developed ventricular tachycardia during exercise testing (five sustained and 39 non-sustained), and 25 did not (group II). After a follow up of 24 (SD 15) months sudden cardiac death occurred in seven patients in group I and in none in group II (P < 0.05). CONCLUSIONS--Ventricular tachycardia on exercise testing is significantly associated with sudden cardiac death in patients with chronic chagasic cardiomyopathy and ventricular arrhythmias.

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