@article{oai:niigata-u.repo.nii.ac.jp:00018571, author = {五十嵐, 裕 and 相沢, 義房}, issue = {6}, journal = {新潟医学会雑誌, 新潟医学会雑誌}, month = {Jun}, note = {We analyzed the long-term outcome of antiarrhythmic therapy, each of which had been evaluated at electrophysiologic study (EPS), to identify the high risk group of sudden death and cardiac mortality. The subject consisted of 72 patients with ventricular tachyarrhythmias. All patients had spontaneous sustained ventricular tachycardia (VT) or ventricular fibrillation (VF). Sustained ventricular tachyarrhythmias were induced in 65 (91 %) patients at control EPS. Antiarrhythmic therapy was considered effective if VT induction was suppressed to fewer than six ventricular complexes. In 43 patients (Group I), antiarrhythmic therapy (antiarrhythmic agents, cathether ablation or surgery) was judged to be effective by EPS, and in 22 (Group II) antiarrhythmic therapy ineffective. During a mean follow-up period of 35 months, sudden death occurred in one (2 %) patient in group I and 6 (27%) in group II (p=0.049), and cardiac mortality was 4 % in group I and 36 % in group II (p=0.002). By life table analysis, the 5-year sudden death free-survival was 82.9 % in group I and 46.7 % in group II (p<0.01). Subgroup analysis identified the patients with old myocardial infarction as a high risk group of sudden death if EPS-guided antiarrhythmic therapy is ineffective. On multiple regression analysis of 10 clinical variables, no effective therapy guided by EPS and induction of VF or VT degenerated into VF were independent predictors of sudden death, and resting left ventricular function was an only independent predictor of cardiac mortality. It is concluded that suppression of inducible ventricular tachyarrhythmia during EPS predicts a favorable outcome. Patients in whom ventricular tachyarrhythmia is not prevented are at high risk for sudden death especially in patients with old myocardial infarction.}, pages = {268--276}, title = {3)頻拍性心室性不整脈の電気生理検査を基にした治療成績 : 特に基礎心疾患と突然死について(シンポジウム 突然死をめぐる諸問題, 第504回新潟医学会)}, volume = {109}, year = {1995} }