Long-term prognosis of inducible ventricular flutter: not an innocent finding

Am Heart J. 2004 Apr;147(4):649-54. doi: 10.1016/j.ahj.2003.11.012.


Background: The prognostic significance of ventricular flutter (VFL) induced during programmed electrical stimulation (PES) is currently unknown.

Methods: This study examined patients who had PES-induced VFL and assessed their long-term prognosis compared with patients who had inducible sustained monomorphic ventricular tachycardia (SMVT).

Results: Of 3414 patients undergoing PES, 74 (2%) had sustained VFL. They were compared with a group of 71 patients undergoing PES in the same time frame who had inducible SMVT. Patients with inducible VFL had a higher ejection fraction than patients with SMVT (0.39 vs 0.33; P =.05). More aggressive pacing was required for arrhythmia induction in patients with VFL, with more stimuli (2.7 +/- 0.5 vs 2.2 +/- 0.6; P <.01) and tighter S(2), S(3), and S(4) intervals. After a mean follow-up of 30 +/- 31 months, the mortality rate was 34% in patients with VFL and 30% in patients with SMVT (P =.41). No difference in the 2 groups in overall survival or a combined end point of sudden death or appropriate implantable cardioverter defibrillator shock was revealed with Kaplan-Meier analysis.

Conclusion: The long-term prognosis of patients with inducible VFL is similar to that of patients with inducible SMVT, even when VFL is induced with a relatively aggressive protocol.

Publication types

  • Comparative Study

MeSH terms

  • Arrhythmias, Cardiac / diagnosis
  • Arrhythmias, Cardiac / etiology
  • Arrhythmias, Cardiac / mortality*
  • Cause of Death
  • Electrophysiologic Techniques, Cardiac*
  • Follow-Up Studies
  • Heart Ventricles
  • Humans
  • Prognosis
  • Risk
  • Stroke Volume
  • Survival Rate
  • Tachycardia, Ventricular / diagnosis
  • Tachycardia, Ventricular / etiology
  • Tachycardia, Ventricular / mortality