−}−ÑflÇ-Œ{ŁÒ01-01

Transcription

1 2005 Guidelines for Non-Pharmacological Therapy of Cardiac Arrhythmias (JCS 2006) NTT WPW

2 ICD 2000 ICD , ,470 MADIT SCD-HeFT 2005 ICD NYHA CRT MIRACLE QOL 2001 FDA ICD CRT-D COMPANION 2002 FDA 5 ICD ICD 2004 CRT 2006 CRT-D , CAST Cardiac Arrhythmia Suppression Trial catheter ablation implantable cardioverter-defibrillator: ICD % % 1996 cardiac resynchronization therapy: CRT % CRT-D

3 amiodarone quinidine Vaughan Williams CAST amiodarone Sicilian Gambit WPW Maze CRT CRT-D CRT-D 3,000 2,500 2,000 1,500 1,

4 % 3% 6% 10% 34% 19% 3% ARVC HCM 12% DCM 16% 81% DCM HCM ARVC 2 3 ACC AHA ACC AHA a b 4 mortality morbidity quality of life, QOL Adams-Stokes 4

5 T wave alternans ,

6 informed consent 1969 Scherlag His 12

7 Mobitz Wenckebach HV HV head-up tilt QOL His His His-Purkinje Class a His-Purkinje mg kg 0.2 mg kg 19 7

8 narrow QRS 2 wide QRS 3 WPW narrow QRS 30 narrow QRS 120 msec wide QRS WPW

9 ESVEM Electrophysiological Study Versus Electrocardiographic Monitoring AVID Antiarrhythmics Versus Implantable Defibrillators 48 Vaughan Williams QOL 1 3 % Brugada 4 WPW QT T wave alternans 40 % WPW 38 QT QT torsades de pointes Brugada V1-3 ST % Brugada

10 QOL AHA ACC AHA ACC His His 2 1 His His Wenckebach

11 Mobitz Wenckebach His His His His- Purkinje His HV 100 msec 150 His His a His His

12 headup tilt 2 1 Head-up tilt 94 head-up tilt Gilgenkrantz Hassenstein Maron 116 PIC Pacing in Cardiomyopathy 117 PTSMA PTSMA 30 mmhg 50 mmhg

13 HV 4 1 QRS WPW % mm large tip 139 large tip WPW Kent % % 141 CARTO 1 1 QOL 2 13

14 QOL WPW Kent QOL WPW RR 220 msec 250 msec WPW 95 % 5 % 1 2 % 1 2 % 2 1 QOL * 2. 1 QOL * 1* 2 QOL * 7 24 AFFIRM Atrial Fibrillation Follow-up Investigation of Rhythm ManagementQOL 14

15 % % % 74 % 12 p % :1 QOL :

16 Kent Mahaim wide QRS PJRT permanent form of junctional reciprocating tachycardia Kent QOL QOL 1 QOL 16

17 2 CAST 1 QOL Na K QOL WPW Mirowski FDA 250 cc 225 g cc 80 g 1 % 5 %

18 VVI DDD ACC/AHA/NASPE mmHg WPW NYHA % %

19 AVID Anti-arrhythmics Versus Implantable Defibrillators % 35 % % % % 1 35 % NYHA 35 % 1 30 % MADIT Multicenter Automatic Defibrillator Implantation Trial 270 MUSTT Multicenter Unsustained Tachycardia Trial 271 MADIT % % 19

20 % % MUSTT 271 MADIT MUSTT MADIT % SCD-HeFT Sudden Cardiac Death in Heart Failure Trial % NYHA %

21 Brugada coved ST 1 Brugada coved ST 1 Brugada saddle-back ST Brugada V1-3 ST 298 Brugada ST Brugada sign Brugada 246 Brugada sign Ia Ic Brugada coved ST 0.2 mv 45 coved ST 301 Ia Ic Brugada 302 Brugada Brugada 3 chromosome 3 Na SCN5A Brugada Na 303 Brugada Brugada Brugada Brugada % 304 Brugada 306 Brugada

22 torsades de pointes 1 QT torsades de pointes 310 QT % QT 9 % QT 25 % QT QT 2 1 % Silka % 8 57 %1996 Groh torsades de pointes QT % QT QT QT torsades de pointes QT QT QT % QT

23 1 1 NYHA 35 % QRS 130 msec 2 NYHA 35 % 1 NYHA 35 % 2 1 NYHA 35 % QRS 130 msec a 1 NYHA 35 % 327 Cardiac Resynchronization Therapy CRT 328 QOL CRT Couch Sealy Iwa 333 WPW WPW % maze Dor maze Dor 23

24 QOL 2 1 maze % maze 348 maze 349 maze QOL maze maze maze Fontan Total Cavopulmonary Connection: TCPC 3 QOL WPW 1 24

25 Fontan Mustard Senning isthmus-dependent atrial flutter incisional atrial reentry Fontan Total Cavopulmonary Connection: TCPC WPW QOL QOL 25

26 The Cardiac Arrhythmia Suppression Trial (CAST) Investigators Preliminary report: Effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 1989; 321: Myerberg RJ, Castellanos A: Cardiac arrest and sudden cardiac death; In Braunwald E (ed): The Heart Disease. Philadelphia, WB Saunders, 1988; p Bayes de Luna A, Coumel P, Leclercq JF: Ambulatory sudden cardiac death; mechanisms of production of fatal arrhythmia on the basis data from 157 cases. Am Heart J 1989; 117: : 1997; p : Excerpta Medica, : 1998; 18(suppl 1): : ICD 1998; p Gregoratos G, Cheitlin MD, Conill A, Epstein AE, Fellows C, Ferguson TB Jr, et al: ACC/AHA guidelines for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Pacemaker Implantation). J Am Coll Cardiol 1998; 31: Gregoratos G, Cheitlin MD, Conill A, Epstein AE, Fellows C, Ferguson TB Jr, et al: ACC/AHA Guidelines for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices: Executive Summary-a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on Pacemaker Implantation). Circulation 1998; 97: ACC/AHA Task Force Report. Guidelines for Clinical Intracardiac Electrophysiological and Catheter Ablation Procedures. A report of the American College of Cardiology /American Heart Association task force on practice guidelines (Committee on Clinical Intracardiac Electrophysiologic and Catheter Ablation Procedures). Developed in collaboration with the North American Society of Pacing and Electophysiology. J Cardiovasc Electrophysiol 1995; 6: Guidelines for Clinical Intracardiac Electrophysiological and Catheter Ablation Procedures: A rreport of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Clinical Intracardiac Electrophysiologic and Catheter Ablation Procedures). Developed in collaboration with the North American Society of Pacing and Electrophysiology. Circulation 1995; 92: Gregoratos G, Abrams J, Epstein AE, Freedman RA, Hayes DL, Hlatky, MA, et al: ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committee to Update the 1998 Pacemaker Guidelines). Circulation 2002; 106: Meltzer S, Leiter L, Daneman D, Cerstein HC, Lau D, Ludwig S, et al: 1998 clinical practice guidelines for the management of diabetes in Canada. Can Med Assoc J 1998; 159(8 suppl): S : 1990; 6: Mandel WJ, Hayakawa H, Allen HN, Danzig R, Kermaier AI: Assessment of sinus node function in patients with the sick sinus syndrome. Circulation 1972; 46: Jordan JL, Yamaguchi I, Mandel WJ: Studies on the mechanism of sinus node dysfunction in the sick sinus syndrome. Circulation 1978; 57: Kasanuki H: Electrophysiological and clinical study of sick sinus syndrome using the overdrive suppression test. Jpn Circ J 1980; 44: : Overdrive suppression test SSS 1996; 16: : overdrive suppression overdrive suppression ; 16: Narula OS, Scherlag BJ, Javier RP, Hildner FJ, Samet P: Analysis of the A-V conduction defect in complete heart block utilizing His bundle electrograms. Circulation 1970; 41: : 1986; 34: : 1987; 3: Sra J, Jazayeri MR, Avitall B, Dhala A, Deshpanda S, Blanck Z, et al: Comparison of cardiac pacing with drug therapy in the treatment of neurocardiogenic vasovagal syncope with bradycardia or asystole. N Engl J Med 1993; 328: : 1987; 57: Scheinmann MM, Peters RW, Modin G, Brennan M, Mies C, O'Young J: Prognostic value of infranodal conduction time in patients with chronic bundle branch block. Circulation 1977; 56: Englund A, Bergfeldt L, Rosenqvist M: Pharmacological stress testing of the His-Purkinje system in patients with bifascicular block. PACE 1998; 21: Scheinman MM, Weiss AN, Shafton E, Benowits N, Rowland M: Electrophysiologic effects of procaine amide in patients with 26

27 intraventricular conduction delay. Circulation 1974; 49: Fananapazir L, Epstein ND, Curiel RV, Panza JA, Tripodi D, McAreavey D: Long-term results of dual-chamber (DDD) pacing in obstructive hypertrophic cardiomyopathy. Evidence for progressive symptomatic and hemodynamic improvement and reduction of left ventricular hypertrophy. Circulation 1994; 90: Auricchio A, Stellbrink C, Block M, Sack S, Vogt J, Bakker P, et al: Effect of pacing chamber and atrioventricular delay on acute systolic function of paced patients with congestive heart failure. Circulation 1999; 99: : 1988; p Hirao K, Otomo K, Wang X, Beckman KJ, McClelland JH, Widman L, et al: Para-Hisian pacing. A new method for differentiating retrograde conduction over an accessory AV pathway from conduction over the AV node. Circulation 1996; 94: Takahashi A, Iesaka Y, Igawa M, Tokunaga T, Amemiya H, Fujiwara H, et al: Atrioventricular nodal physiology after slow pathway ablation. PACE 1994; 17: Nogami A, Suguta M, Tomita T, Naito S, Taniguchi K, Aonuma K, et al: Novel form of atrial tachycardia originating at the atrioventricular annulus. PACE 1998; 21: Kasanuki H, Ohnishi S, Tanaka E, Hirosawa K: Idiopathic sustained ventricular tachycardia responsive to verapamil: Clinical electrocardiographic and electrophysiologic considerations. Jpn Circ J 1986; 50: : 1992; p Chinushi M: Long-term results of radiofrequency catheter ablation in non-ischemic sustained ventricular tachycardia with underlying heart disease.nonuniform arrhythmogenic substrate and mode of ablation. Jpn Heart J 1996; 37: Suyama K, Kurita T, Shimizu W, Matsuo K, Taguchi A, Aihara N, et al: Radiofrequency catheter ablation of concealed atrioventricular accessory pathways using a "simultaneous" pacing method. PACE 1998; 21: Satoh M, Aizawa Y, Funazaki T, Niwano S, Ebe K, Miyajima S, et al: Electrophysiologic evaluation of asymptomatic patients with the Wolff-Parkinson-Whitte pattern. PACE 1989; 12: Kasanuki H, Ohnishi S, Hirosawa K: Availability of electrophysiological approach to the selection and assessment of antiarrhythmic drugs for recurrent ventricular tachycardia. Jpn Circ J 1983; 47: Kasanuki H, Onishi S, Hirosawa K: The Usefulness of electrophysiological-pharmacologic studies in the long-term therapy of paroxysmal tachycardias. Jpn Circ J 1985; 49: Ebe K, Aizawa Y, Shibata A: Clinical characteristics and EPS-guided therapy in 142 cases of sustained ventricular tachycardia. Jpn Heart J 1996; 37: Niwano S, Furushima H, Taneda K, Abe A, Ohira K, Aizawa Y: The usefulness of Holter monitoring in selecting pharmacologic therapy for patients with sustained monomorphic ventricular tachycardia. Studies in patients in whom no effective pharmacologic therapy could be determined by electrophysiologic study. Jpn Circ J 1998; 62: Kasanuki H, Ohnishi S, Nirei T, Shoda M, Hosada S: Evaluation of proarrhythmic effect of antiarrhythmic drugs on ventricular tachycardia associated with congestive heart failure. Jpn Circ J 1992; 56: Chinushi M, Aizawa Y, Miyajima S, Funazaki T, Tamura M, Shibata A: Proarrhythmic effects of antiarrhythmic drugs assessed by electrophysiologic study in recurrent sustained ventricular tachycardia. Jpn Circ J 1991; 55: Mason JW for the ESVEM Investigators: A comparison of seven antiarrhythmic drugs in patients with ventricular tachyarrhythmias. N Engl J Med 1993; 329: Niwano S, Yamaura M, Yoshizawa N, Moriguchi M, Kitano Y, Aizawa Y, et al: Electrophysiologic parameters to predict clinical recurrence of ventricular tachycardia in patients under electrophysiologic study-guided effective pharmacological therapy. Jpn Circ J 1999; 63: The Antiarrhythmics Versus Implantable Defibrillators (AVID) Investigators: A comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N Engl J Med 1997; 337: Iesaka Y, Nogami A, Aonuma K, Nitta J, Chun YH, Fujiwara H et al: Prognostic significance of sustained monomorphic ventricular tachycardia induced by programmed ventricular stimulation using up to triple extrastimuli in survivors of acute myocardial infarction. Am J Cardiol 1990; 65: Miyajima S, Aizawa Y, Suzuki K, Satoh M, Niwano S, Ebe K, et al: Sustained ventricular tachycardia responsive to verapamil in patients with hypertrophic cardiomyopathy. Jpn Heart J 1989; 30: Iesaka Y, Hiroe M, Aonuma K, Nitta J, Nogami A, Tokunaga T, et al: Usefulness of electrophysiologic study and endomyocardial biopsy in differentiating arrhythmogenic right ventricular dysplasia from idiopathic right ventricular tachycardia. Heart Vessels Suppl 1990; 5: Takahashi M, Kimura M, Kobayashi I, Aizawa Y, Shibata A: Clinical value of electrophysiologic study in patients with nonsustained ventricular tachycardia. Jpn Heart J 1994; 35: Shimizu W, Ohe T, Kurita T, Takaki H, Aihara N, Kamakura S, et al: Early afterdepolarizations induced by isoproterenol in patients with congenital long QT syndrome. Circulation 1991; 84: Washizuka T, Aizawa Y, Chinushi M, Niwano S: QT prolongation induced by intracoronary acetylcholine in congenital long QT syndrome. Heart Vessels Suppl 1995; 9: Ohe T, Kurita T, Aihara N, Kamakura S, Matsuhisa M, Shimomura K: Electrocardiographic and electrophysiologic studies in patients with torsades de pointes-role of monophasic action potentials. Jpn Circ J 1990; 54:

28 : ST. 1995; 15: Fujimori K, Hen Y, Hirata N, Yonemura F, Fujii S, Tanizaki K, et al: Incidence of asymptomatic Burugada syndrome among middle to High-aged subjects: An exhaustive investigation of local residents in Miyagi Prefecture. Jpn Circ J 2001; 65(Suppl 1): 504(abstract). 58 Atarashi H, Ogawa S, Harumi K, Hayakawa H, Sugimoto T, Okada R, and Idiopathic Ventricular Fibrillation Investigators: Characteristics of patients with right bundle branch block and ST-segment elevation in right precordial leads. Am J Cardiol 1996; 78: Aizawa Y, Naitoh N, Washizuka T, Takahashi K, Uchiyama H, Shibata M, et al: Electrophysiological findings in idiopathic recurrent ventricular fibrillation: Special reference to mode of induction, drug testing, and long-term outcomes. PACE 1996; 19: Ozawa Y, Yakubo S, Tanigawa N, Nagasawa M, Kojima R, Jinno K, et al: The clinical evaluation of the late potentials in patients with ventricular arrhythmias. Jpn Circ J 1987; 51: : 1994; 22: : ; 11: : His-Purkinje Wenckebach 1996; 16: Sumiyoshi M, Nakata Y, Yasuda M, Tokano Y, Ohno Y, Ogura S, et al: Changes of conductivity in patients with secondor third-degree atrioventricular block after pacemaker implantation. Jpn Circ J 1995; 59: Nakazato Y, Nakata Y, Takano T, Yasuda M, Ohno Y, Hisaoka T, et al: Intra-His bundle block corresponds with interruption of the branching portion of the His bundle. PACE 1994; 17: : 1988; 34: : Ia 1997; 29: : 1982;2 : 1 : Glikson M, Dearani JA, Hyberger LK, Schaff HV, Hammill SC, Hayes DL: Indications, effectiveness, and long-term dependency in permanent pacing after cardiac surgery. Am J Cardiol 1997; 80: Langberg JJ, Chin MC, Rosenqvist M,, Cockrell J, Dullet N, Van Hare G, et al: Catheter ablation of the atrioventricular junction with radiofrequency energy. Circulation 1989; 80: Strasberg B, Amat-Y-Leon F, Dhingra RC, Palileo E, Swiryn S, Bauernfeind R, et al: Natural history of chronic second-degree atrioventricular nodal block. Circulation 1981; 63: Ector H, Rolies L, De Geest H: Dynamic electrocardiography and ventricular pause of 3 seconds and more:etiology and therapeutic implications. PACE 1983; 6: Penton GB, Miller H, Levine S: Some clinical features of complete heart block. Circulation 1956; 13: McAnulty JH, Rahimtoola SH, Murphy E, DeMots H, Ritzmann L, Kanarek PE, et al: Natural history of "highrisk"bundle-branch block: final report of a prospective study. N Engl J Med 1982; 307: Scheinman MM, Peters W, Suave MJ, Desai J, Abbott JA, Cogan J, et al: Value of H-Q interval in patients with bundle branch block and the role of prophylactic permanent pacing. Am J Cardiol 1982; 50: Dhingra RC, Wyndham C, Bauernfeind R, Swiryn S, Deedwania PC, Smith T, et al: Significance of block distal to the His bundle induced by atrial pacing in patients with chronic bifascicular block. Circulation 1979; 60: Shaw DB, Holman RR, Gowers JI: Survival in sinoatrial disorder (sick sinus syndrome). Br Med J 1980; 280: Kay R, Estioko M, Wiener I: Primary sick sinus syndrome as an indication for chronic pacemaker therapy in young adults: incidence, clinical features, and long-term evaluation. Am Heart J 1982; 103: Kusumoto FM, Goldschlager N: Cardiac pacing. N Engl J Med 1996; 334: Dreifus LS, Michelson EL, Kaplinsky E: Bradyarrhythmias: clinical significance and management. J Am Coll Cardiol 1983; 1: Rasmussen K: Chronic sinus node disease: natural course and indications for pacing. Eur Heart J 1981; 2: Rubenstein JJ, Schulman CL, Yurchak PM, DeSanctis RW: Clinical spectrum of the sick sinus syndrome. Circulation 1972; 46: : 1977; 9: Fukatani M, Hashiba K: Long-term follow-up after cardiac pacing in bradyarrhythmias. Jpn Circ J 1978; 42: Yanaga T, Otsuka K, Ichimaru Y, Hata Y, Okamoto K, Nakanishi H, et al: Usefulness of 24-hour recordings of electrocardiogram for the diagnosis and treatment of arrhythmias with special reference to the determination of indication of artificial cardiac pacing. Jpn Circ J 1981; 45: : Sick sinus syndrome : overdrive suppression test 1980; 47: : Sick sinus 1983; 50: :, 1987; p Phibbs B, Friedman HS, Graboys TB, Lown B, Marriott HJL, Nelson WP, et al: Indications for pacing in the treatment of 28

29 bradyarrhythmias. Report of an independent study group. JAMA 1984; 252: Ishikawa T, Sumita S, Kimura K, Kikuchi M, Kosuge T, Endo T, et al: Sinus node recovery time assessment by the overdrive suppression test employing an intravenous injection of disopyramide phosphate. Europace 2000; 2: : pace-maker. 1980; 38: Pitcher D, Papouchado M, James MA, Rees JR: Twenty-four hour ambulatory electrocardiography in patients with chronic atrial fibrillation Br Med J 1986; 292: Pollak A, Falk RH: Pacemaker therapy in patients with atrial fibrillation. Am Heart J 1993; 125: Peretz DI, Gerein AN, Miyagishima RT: Permanent demand pacing for hypersensitive carotid sinus syndrome. Can Med Assoc J 1973; 108: Kenny RA, Ingram A, Bayliss J, Sutton R: Head-up tilt: a useful test for investigating unexplained syncope. Lancet 1986; 1: Fitzpatrick A, Sutton R: Tilting towards a diagnosis in recurrent unexplained syncope. Lancet 1989; 1: : ; 5: Brignole M, Menozzi C, Gianfranchi L, Oddone D, Lolli G, Bertulla A: Neurally mediated syncope detected by carotid sinus massage and head-up tilt test in sick sinus syndrome. Am J Cardiol 1991; 68: Sutton R, Petersen M, Brignole M, Raviele A, Menozzi C, Giani P: Proposed classification for tilt-induced vasovagal syncope. Eur J Cardiac Pacing Electrophysiol 1992; 2: : ; 40: Petersen ME, Chamberlain-Webber R, Fitzpatrick AP, Ingram A, Williams T, Sutton R: Permanent pacing for cardioinhibitory malignant vasovagal syndrome. Br Heart J 1994; 71: Nishizaki M, Arita M, Sakurada H, Ohta T, Yamawake N, Numano F, et al: Long-term follow-up of the reproducibility of carotid sinus hypersensitivity in patients with carotid sinus syndrome. Jpn Circ J 1995; 59: : head-up tilt test : 1995; 11: Benditt DG, Ferguson DW, Grubb BP, Kapoor WN, Kugler J, Lerman BB, et al: Tilt table testing for assessing syncope. J Am Coll Cardiol 1996; 28: Grubb BP, Gerard G, Roush K, Temesy-Armos P, Elliott L, Hahn H, et al: Differentiation of convulsive syncope and epilepsy with head-up tilt testing. Ann Intern Med 1991; 115: Sumiyoshi M, Nakata Y, Mineda Y: Paroxysmal atrioventricular block induced during head-up tilt testing in an apparently healthy man. J Cardiovasc Electrophysiol 1997; 8: Connolly SJ, Sheldon RS, Roberts RS, Gent M.: The North American Vasovagal Pacemaker Study (VPS). A randomized trial of permanent cardiac pacing for the prevention of vasovagal syncope. J Am Coll Cardiol 1999; 33: : rate-drop response. 2000; 16: Ammirati F, Colivicchi F, Santini M for the Syncope Diagnosis and Treatment Study Investigators : Permanent cardiac pacing versus medical treatment for the prevention of recurrent vasovagal syncope. A multicenter, randomised, controlled trial. Circulation 2001; 104: Gilgenkrantz JM, Cherrier F, Petitier H, Dodinot B, Houplon M, Legoux J: Cardiomyopathie obstructive du ventricule gauche avec bloc auriculo-ventriculaire complet:considerations therapeutiques. Arch Mal Coeur Vaiss 1968; 61: Hassenstein P, Storch HH, Schmitz W: Erfarhrungen mit der schrittmacherdauer behandlung bei Patienten mit obstruck-tiver Kardiomyopathie. Thoraxchir Vask Chir 1975 ; 23: Duport G, Valeix B, Lefevre J, Nebunu JC, Bouteau JM, Garcia-Duport M, et al: Interet de la stimulation ventriculaire droite permanente dens la cardiomyopathtieobstructive. Nouv Presse Med 1978 ; 32 : McDonald K, McWilliams E, O'Keeffe B, Maurer: Functional assessment of patients treated with permanent dual chamber pacing as a primary tretment for hypertrophic cardiomyopathy. Eur Heart J 1988 ;9: Jeanrenaud X, Goy J, Kappenberger L: Effects of dual chamber pacing in hypertrophic obstructive cardiomyopathy. Lancet 1992 ; 339: Fananapazir L, Epstein ND, Curiel RV, Panza JA, Tripodi D McAreavey D : Long term result of dual- chamber (DDD) pacing in obstructive hypertrophic cardiomyopathy. Evidence for progressive symptomatic and hemodynamic improvement and reduction of left ventricular hypertrophy. Circulation 1994; 90: Maron BJ, Nishimura RA, McKenna WJ, Rakowski H, Josephson ME, Kieval RS: Assessment of permanent dualchamber pacing as a treatment for drug-refractory symptomatic patients with obstructive hypertrophic cardiomyopathy. A randomized, double-blind, crossover study (M-PATHY). Circulation 1999; 99: Kappenberger LJ, Linde C, Jeanrenaud X, Daubert C, McKenna W, Meisel E, et al:clinical progress after randomized on/off pacemaker treatment for hypertrophic obstructive cardiomyopathy. Pacing in Cardiomyopathy (PIC) Study Group. Europace 1999 ; 1 : Sakai Y, Kawakami Y, Hirota Y, Ito T, Shimada S, Tokaji Y, et al: Dual-chamber pacing in hypertrophic obstructive cardiomyopathy: a comparison of acute and chronic effects. Jpn Circ J 1999; 63: Meisel E, Rauwolf T, Burghardt M, Kappenberger L: Pacemaker therapy of hypertrophic obstructive cardiomyopathy. PIC Study Group. Herz 2000; 25: Ommen SR, Nishimura RA, Squires RW, Schaff HV, 29

30 2005 Danielson GK, Tajik AJ: Comparison of dual-chamber pacing versus septal myectomy for the treatment of patients with hypertrophic obstructive cardiomyopathy: a comparison of objective hemodynamic and exercise end point. J Am Coll Cardiol 1999: 34: : 2000; 8: Michaelsson M, Jonzon A, Riesenfeld T: Isolated congenital complete atrioventricular block in Adult life. A prospective study. Circulation 1995; 92: Pinsky WW, Gillette PC, Garson A Jr, McNamara DG: Diagnosis, management, and long-term results of patients with congenital complete atrioventricular block. Pediatrics 1982; 69: Sholler GF, Walsh EP: Congenital complete heart block in patients without anatomic cardiac defects. Am Heart J 1989; 118: Dewey RC, Capeless MA, Levy AM: Use of ambulatory electrocardiographic monitoring to identify high-risk patients with congenital complete heart block. N Engl J Med 1987; 316: Lillehei CW, Sellers RD, Bonnabeau RC, Eliot RS: Chronic postsurgical complete heart block. With particular reference to prognosis, management and a new p-wave pacemaker. J Thorac Cardiovasc Surg 1963; 46: Krongrad E: Prognosis for patients with congenital heart disease and postoperative intraventricular conduction defects. Circulation 1978; 57: Gelatt M, Hamilton R, McCrindle BW, Connelly M, Dabis A, Harris L, et al: Arrhythmia and mortality after the Mustard procedure: A 30-year single-center experience, J Am Coll Cardiol 1997; 29: : 1986; 6: : 1990; 43: : 1991; 26: : 1993; 22: : ; 46: : ; 12: : 1998; 30: : DDD ; 45: Gallagher JJ, Svenson RH, Kasell JH, German LD Bardy GH, Broughton A, et al: Catheter technique for closed-chest ablation of the atrioventricular conduction system. N Engl J Med 1982; 306: Huang SK, Bharati S, Graham AR, Lev M, Marcus FI Odell RC: Closed-chest catheter desiccation of the atrioventricular junction using radiofrequency energy-a new method of catheter ablation. J Am Coll Cardiol 1987; 9: Langberg JJ, Chin M, Schamp DJ, Lee MA Goldberger J Pederson DN, et al: Ablation of the atrioventricular junction with radiofrequency energy using a new electrode catheter. Am J Cardiol 1991; 67: : ; 15: Calkins H, Sousa J, el-atassi R, Rosenheck S, de Buitleir M, Kou WH, et al: Diagnosis and cure of the Wolff-Parkinson- White syndrome or paroxysmal supraventricular tachycardias during a single electrophysiologic test. N Engl J Med 1991; 324: Jackman WM, Wang XZ, Friday KJ, Roman CA, Moulton KP, Beckman KJ, et al: Catheter ablation of accessory atrioventricular pathways (Wolff-Parkinson-White syndrome) by radiofrequency current. N Engl J Med 1991; 324: Kuck KH, Schluter M, Geiger M, Siebels J, Duckeck W: Radiofrequency current catheter ablation of accessory atrioventricular pathways. Lancet 1991; 337: Calkins H, Langberg J, Sousa J, el-atassi R, Leon A, Kou W, et al: Radiofrequency catheter ablation of accessory atrioventricular connections in 250 patients: abbreviated therapeutic approach to Wolff-Parkinson-White syndrome. Circulation 1992; 85: Hindricks G for the Multicentre European Radiofrequency Survey (MERFS) Investigators of the Working Group on Arrhythmias of the European Society of Cardiology: The Multicentre European Radiofrequency Survey (MERFS): complications of radiofrequency catheter ablation of arrhythmias. Eur Heart J 1993; 14: Lesh MD, Van Hare GF, Scheinman MM, Ports TA, Epstein LA: Comparison of the retrograde and transseptal methods for ablation of left free wall accessory pathways. J Am Coll Cardiol 1993; 22: Scheinman MM: NASPE Survey on Catheter Ablation. PACE 1995; 18: Calkins H, Yong P, Miller JM, Olshansky B, Carlson M, Saul JP for the Atakr Multicenter Investigators Group: Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction: final results of a prospective, multicenter clinical trial. Circulation 1999; 99: Scheinman MM, Huang S: The 1998 NASPE prospective catheter ablation registry. PACE 2000; 23: Antz M, Weiss C, Volkmer M, Hebe J, Ernst S, Ouyang F, et 30

31 al: Risk of sudden death after successful accessory atrioventricular pathway ablation in resuscitated patients with Wolff-Parkinson-White syndrome. J Cardiovasc Electrophysiol 2002 ;13: Akhtar M, Jazayeri MR, Sra J, Blanck Z, Deshpande S, Dhala A: Atrioventricular nodal reentry: clinical, electrophysiological, and therapeutic considerations. Circulation 1993; 88: Bogun F, Knight B, Weiss R, Bahu M, Goyal R, Harvey M, et al: Slow pathway ablation in patients with documented but noninducible paroxysmal supraventricular tachycardia. J Am Coll Cardiol 1996; 28: Rostock T, Risius T, Ventura R, Klemm HU, Weiss C, Keitel A, et al: Efficacy and safety of radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia in the elderly. J Cardiovasc Electrophysiol 2005; 16: : WPW 1996; 12: : WPW 1998; 18 : ,,,,, : WPW ; 20: Iesaka Y, Takahashi A, Goya M, Yamane T, Kojima S, Fujiwara H, et al: Selective radiofrequency catheter ablation of the slow pathway for common and uncommon atrioventricular nodal reentrant tachycardia. Jpn Heart J 1996; 37: AFFIRM 159 Stabile G, Bertaglia E, Senatore G, de Simone A, Zerbo F, Carreras G, et al: Feasibility of pulmonary vein ostia radiofrequency ablation in patients with atrial fibrillation: a multicenter study (CACAF pilot study). PACE 2003; 26: Wazni OM, Marrouche NF, Martin DO, Verma A, Bhargava M, Saliba W, et al: Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation. a randomized trial. JAMA 2005; 293: Oral H, Pappone C, Chungh A, Good E, Bogun F, Pelosi F Jr, et al: Circumferential pulmonary-vein ablation for chronic atrial fibrillation. N Engl J Med 2006; 354: Haissaguerre M, Shah DC, Jais P, Hocini M, Yamane T, Deisenhofer I, et al: Electrophysiological breakthroughs from the left atrium to the pulmonary veins. Circulation 2000; 102: Pappone C, Rosanio S, Oreto G, Tocchi M, Gugliotta F, Vicedomini G, et al: Circumferential radiofrequency ablation of pulmonary vein ostia: A new anatomic approach for curing atrial fibrillation. Circulation 2000; 102: Cappato R, Calkins H, Chen SA, Davies W, Iesaka Y, Kalman J, et al : Worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circulation 2005; 111: Pappone C, Oral H, Santinelli V, Vicedomini G, Lang CC, Manguso F, et al: Atrio-esophageal fistula as a complication of percutaneous transcatheter ablation of atrial fibrillation. Circulation 2004; 109: Hsu LF, Jais P, Sanders P, Garrigue S, Hocini M, Sacher F, et al: Catheter ablation for atrial fibrillation in congestive heart failure. N Engl J Med 2004; 351: Nademanee K, McKenzie J, Kosar E, Schwab M, Sunsaneewitayakul B, Vasavakul T, et al: A new approach for catheter ablation of atrial fibrillation: mapping of the eletrophysiologic substrate. J Am Coll Cardiol 2004; 43: Williamson BD, Man KC, Daoud E, Niebauer M, Strickberger SA, Morady F: Radiofrequency catheter modification of atrioventricular conduction to control the ventricular rate during atrial fibrillation. N Engl J Med 1994; 331: Feld GK, Fleck RP, Chen PS, Boyce K, Bahnson TD, Stein JB, et al: Radiofrequency catheter ablation for the treatment of human type I atrial flutter: Identification of a critical zone in the reentrant circuit by endocardial mapping techniques. Circulation 1992; 86: Lee SH, Tai CT, Yu WC, Chen YJ, Hsieh MH, Tsai CF, et al: Effects of radiofrequency catheter ablation on quality of life in patients with atrial flutter. Am J Cardiol 1999; 84: Cheng J, Cabeen WR Jr, Scheinman MM: Right atrial flutter due to lower loop reentry: mechanism and anatomic substrates. Circulation 1999; 99: Triedman JK, Alexander ME, Berul CI, Bevilacqua LM, Walsh EP : Electroanatomic mapping of entrained and exit zones in patients with repaired congenital heart disease and intra-atrial reentrant tachycardia. Circulation 2001; 103: Goya M, Iesaka Y, Takahashi A, Mitsuhashi T, Yamane T, Soejima Y, et al: Radiofrequency catheter ablation for sinoatrial node reentrant tachycardia: electrophysiologic features of ablation sites. Jpn Circ J 1999; 63: Iesaka Y, Takahashi A, Goya M, Soejima Y, Okamoto Y, Fujiwara H, et al: Adenosine-sensitive atrial reentrant tachycardia originating from the atrioventricular nodal transitional area. J Cardiovasc Electrophysiol 1997; 8: Chen SA, Tai CT, Chiang CE, Ding YA, Chang MS: Focal atrial tachycardia: reanalysis of the clinical and electrophysiologic characteristics and prediction of successful radiofrequency ablation. J Cardiovasc Electrophysiol 1998; 9: Chen SA, Chiang CE, Yang CJ, Cheng CC, Wu TJ, Wang SP, et al: Sustained atrial tachycardia in adult patients. Electrophysiological characteristics, pharmacological response, possible mechanisms, and effects of radiofrequency ablation. Circulation 1994; 90: Man KC, Knight B, Tse HF, Pelosi F, Michaud GF, Flemming M, et al: Radiofrequency catheter ablation of inappropriate sinus tachycardia guided by activation mapping. J Am Coll Cardiol 2000; 35: Callans DJ, Ren JF, Schwartzman D, Gottlieb CD, Chaudhry FA, Marchlinski FE: Narrowing of the superior vena cava-right atrium junction during radiofrequency catheter ablation for inappropriate sinus tachycardia: analysis with intracardiac echocardiography. J Am Coll Cardiol 1999; 33: Okishige K, Goseki Y, Itoh A, Tsuboi N, Sasano T, Azegami 31

32 2005 K, et al: New electrophysiologic features and catheter ablation of atrioventricular and atriofascicular accessory pathways: evidence of decremental conduction and the anatomic structure of the Mahaim pathway [see comments]. J Cardiovasc Electrophysiol 1998; 9: Kusumoto FM, Lesh MD: Radiofrequency catheter ablation of an atriofascicular connection guided by direct recording of a Mahaim potential. Am Heart J 1995; 129: McClelland JH, Wang X, Beckman KJ, Hazlitt HA, Prior MI, Nakagawa H, et al: Radiofrequency catheter ablation of right atriofascicular (Mahaim) accessory pathways guided by accessory pathway activation potentials. Circulation 1994; 89: Haissaguerre M, Shah DC, Jais P, Shoda M, Kautzner J, Arentz T, et al: Role of Purkinje conducting system in triggering idiopathic ventricular fibrillation. Lancet 2002; 359: Haissaguerre M, Shoda M, Jais P, Nogami A, Shah DC, Kautzner J, et al: Mapping and ablation of idiopathic ventricular fibrillation. Circulation 2002;106: Nagasawa H, Fujiki A, Usui M, Mizumaki K, Hayashi H, Inoue H: Successful radiofrequency catheter ablation of incessant ventricular tachycardia with a delta wave-like beginning of the QRS complex. Jpn Heart J 1999; 40: Shimoike E, Ueda N, Maruyama T, Kaji Y: Radiofrequency catheter ablation of upper septal idiopathic left ventricular tachycardia exhibiting left bundle branch block morphology. J Cardiovasc Electrophysiol 2000; 11: Nogami A, Naito S, Tada H, Oshima S, Taniguchi K, Aonuma K, et al: Verapamil-sensitive left anterior fascicular ventricular tachycardia: results of radiofrequency ablation in six patients. J Cardiovasc Electrophysiol 1998; 9: Tada H, Nogami A, Naito S, Tomita T, Oshima S, Taniguchi K, et al: Retrograde Purkinje potential activation during sinus rhythm following catheter ablation of idiopathic left ventricular tachycardia. J Cardiovasc Electrophysiol 1998; 9: Kamakura S, Shimizu W, Matsuo K, Taguchi A, Suyama K, Kurita T, et al: Localization of optimal ablation site of idiopathic ventricular tachycardia from right and left ventricular outflow tract by body surface ECG. Circulation 1998; 98: Chinushi M, Aizawa Y, Ohhira K, Fujita S, Shiba M, Niwano S, et al: Repetitive ventricular responses induced by radiofrequency ablation for idiopathic ventricular tachycardia originating from the outflow tract of the right ventricle. PACE 1998; 21: Washizuka T, Aizawa Y, Chinushi M, Naitoh N, Miyajima T, Kusano Y, et al: Alternation of QRS morphology and effect of radiofrequency ablation in idiopathic ventricular tachycardia. PACE 1995; 18: Nakagawa H, Beckman KJ, McClelland JH, Wang X, Arruda M, Santoro I, et al: Radiofrequency catheter ablation of idiopathic left ventricular tachycardia guided by a Purkinje potential. Circulation 1993; 88: Kusano KF, Emori T, Morita H, Ohe T: Ablation of ventricular tachycardia by isolating the critical site in a patient with arrhythmogenic right ventricular cardiomyopathy. J Cardiovasc Electrophysiol 2000; 11: Harada T, Aonuma K, Yamauchi Y, Igawa M, Hachiya H, Oh JC, et al: Catheter ablation of ventricular tachycardia in patients with right ventricular dysplasia: Identification of target sites by entrainment mapping techniques. PACE 1998; 21: Yamauchi Y, Nogami A, Naito S, Tsuchio Y, Aonuma K, Iesaka Y, et al: Catheter ablation for ventricular tachycardia from a diverticulum at the right ventricular outflow tract. PACE 1998; 21: Umemura J, Kasanuki H, Ohnishi S, Shoda M, Hosoda S: Recent experience in treating patients with arrhythmogenic right ventricular dysplasia; In Sekiguchi M, Olsen EG, (eds): Cardiomyopathy Update 5: Prognosis and treatment of cardiomyopathies and myocarditis. Japan, Univ Tokyo Press, 1994; p Shiraishi H, Shirayama T, Inoue K, Tanaka H, Kuwabara H, Inoue D, et al: Successful catheter ablation against ventricular tachycardia associated with myotonic dystrophy. Intern Med 2000; 39: Harada T, Stevenson WG, Kocovic DZ, Friedman PL: Catheter ablation of ventricular tachycardia after myocardial infarction: relation of endocardial sinus rhythm late potentials to the reentry circuit. J Am Coll Cardiol 1997; 30: Aizawa Y, Chinushi M, Naitoh N, Kitazawa H, Washizuka T, Uchiyama H, et al: Catheter ablation of ventricular tachycardia with radiofrequency currents, with special reference to the termination and minor morphologic change of reinduced ventricular tachycardia. Am J Cardiol 1995; 76: Lundberg A: Paroxysmal tachycardia in infancy: Follow-up study of 47 subjects in age from 10 to 26 years. Pediatrics 1973; 51: Blaufox AD, Felix GL, Saul JP;Pediatric Catheter Ablation Registry: Radiofrequency catheter ablation in infants </=18 months old: when is it done and how do they fare? short-term data from the pediatric ablation registry. Circulation 2001; 104: Aiyagari R, Saarel EV, Etheridge SP, Bradley DJ, Dick M 2nd, Fischbach PS: Radiofrequency ablation for supraventricular tachycardia in children < or =15 kg is safe and effective. Pediatr Cardiol 2005; 26: Joung B, Lee M, Sung JH, Kim JY, Ahn S, Kim S: Pediatric radiofrequency catheter ablation: sedation methods and success, complication and recurrence rates. Circ J 2006; 70: McDaniel GM, Van Hare GF: Catheter ablation in children and adolescents. Heart Rhythm 2006; 3: : WPW 1986; 90: Perry JC, Garson A Jr: Supraventricular tachycardia due to Wolff-Parkinson-White syndrome in children: Early disappearance and late recurrence. J Am Coll Cardiol 1990: 16: Mehta AV, Sanchez GR, Sacks EJ, Casta A, Dunn JM, Donner RM: Ectopic automatic atrial tachycardia in children: Clinical characteristics, management and follow-up. J Am Coll Cardiol 1988; 11: Deal BJ, Keane JF, Gillette PC, Garson A Jr: Wolff- Parkinson-White syndrome and supraventricular tachycardia during infancy: Management and follow-up. J Am Coll Cardiol 1985; 5:

33 208 : 1993; 9: Kugler JD, Danford DA, Houston K, Felix G: Radiofrequency catheter ablation for paroxysmal supraventricular tachycardia in children and adolescents without structural heart disease. Pediatric EP Society Radiofrequency Catheter Ablations Registry. Am J Cardiol 1997; 80: KuglerJD, Danford DA, Deal BJ, Gillette PC, Perry JC, Silka MJ,et al: Radiofrequency catheter ablation for tachyarrhythmias in children and adolescents. The Pediatric Electrophysiology Society. N Engl J Med 1994; 330: Weber HS, Hellenbrand WE,Kleinman CS, Perlmutter RA, Rosenfeld LE: Predictors of rhythm disturbances and subsequent morbidity after the Fontan operation. Am J Cardiol 1989; 64: Garson A Jr, Kanter RJ: Management of the child with Wolff- Parkinson-White syndrome and supraventricular tachycardia: model for cost effectiveness. J Cardiovasc Electrophysiol 1997; 8: : ; 13: :. 1997; 13: : 1998; 14: Mirowski M, Reid PR, Winkle RA, Mower MM, Watkins L Jr, Stinson EB, et al: Mortality in patients with implanted automatic defibrillators. Ann Intern Med 1983; 98: Winkle RA, Mead RH, Ruder MA, Gaudiani VA, Smith NA, Buch WS, et al: Long-term outcome with the automatic implantable cardioverter-defibrillator. J Am Coll Cardiol 1989; 13: Zipes DP, Roberts D for the Pacemaker-Cardioverter- Defibrillator Investigators: Results of the international study of the implantable pacemaker cardioverter-defibrillator. A comparison of epicardial and endocardial lead systems. Circulation 1995; 92: Connolly SJ, Dorian P, Roberts RS, Gent M, Bailin S, Fain ES,et al: Comparison of beta-blockers, amiodarone plus betablockers, or sotalol for prevention of shocks from implantable cardioverter defibrillators: the OPTIC Study: a randomized trial. JAMA 2006:295: Wilkoff BL, Cook JR, Epstein AE, Greene HL, Hallstrom AP, Hsia H, et al: Dual-chamber pacing or ventricular backup pacing in patients with an implantable defibrillator: the Dual Chamber and VVI Implantable Defibrillator (DAVID) Trial. JAMA 2002; 288: : 1990; 6: : - Ventak-P ; 10: : -PCD7217B ; 10 : : - Ventak-PRX II ; 13: : 4 -Jewel Plus ; 14: : 4 -Ventak-MINI ; 14: Mitchell LB: Clinical trials of antiarrhythmic drugs in patients with sustained ventricular tachyarrhythmias. Curr Opin in Cardiol 1997; 12: Wilber DJ, Garan H, Finkelstein D, Kelly E, Newell J, McGovern B, et al: Out-of-hospital cardiac arrest : use of electrophysiologic testing in the prediction of long-term outcome. N Engl J Med 1988; 318: Kim YH, Sosa-Suarez G, Trouton TG, O'Nunain SS, Osswald S, McGovern BA, et al: Treatment ventricular tachycardia by transcatheter radiofrequency ablation in patients with ischemic heart disease. Circulation 1994; 89: Gonska BD, Cao K, Schaumann A, Dorszewski A, von zur Muhlen F, Kreuzer H: Catheter ablation of ventricular tachycardia in 136 patients with coronary artery disease: results and long-term follow-up. J Am Coll Cardiol 1994; 24: Strickberger SA, Man KC, Daoud EG, Goyal R, Brinkman K, Hasse C, et al: A prospective evaluation of catheter ablation of ventricular tachycardia as adjuvant therapy in patients with coronary artery disease and an implantable cardioverterdefibrillator. Circulation 1997; 96: Anderson J: Implantable defibrillators are preferable to pharmacologic therapy for patients with ventricular tachyarrhythmias: an antagonist's viewpoint. Prog Cardiovasc Dis 1996; 38: Saksena S, Madan N, Lewis C: Implanted cardioverterdefibrillators are preferable to drugs as primary therapy in sustained ventricular tachyarrhythmias. Prog Cardiovasc Dis 1996; 38: Kim SG: Evolution of the management of malignant ventricular tachyarrhythmias: The roles of drug therapy and implantable defibrillators. Am Heart J 1995; 130: Bocker D, Block M, Borggrefe M, Breithardt G: Defibrillators are superior to antiarrhythmic drugs in the treatment of ventricular tachyarrhythmias. Eur Heart J 1997; 18: Zipes DP: Are implantable cardioverter defibrillators better than conventional antiarrhythmic drugs for survivors of cardiac arrest? Circulation 1995; 91: Sweeney MO, Ruskin JN: Mortality benefits and the implantable cardioverter-defibrillator. Circulation 1994; 89: 33

34 Cox JL: Patient selection criteria and results of surgery for refractory ischemic ventricular tachycardia. Circulation 1989; 79 (suppl I): Thomas AC, Moser SA, Smutka ML, Wilson PA: Implantable defibrillation: Eight years clinical experience. PACE 1988; 11: Fogoros RN, Elson JJ, Bonnet CA, Fiedler SB, Burkholder JA: Efficacy of the automatic implantable cardioverterdefibrillator in prolonging survival in patients with severe underlying cardiac disease. J Am Coll Cardiol 1990; 16: Powell AC, Fuchs T, Finkelstein DM, Garan H, Cannom DS, McGovern BA, et al: Influence of implantable cardioverterdefibrillators on the long-term prognosis of survivors of out-ofhospital cardiac arrest. Circulation 1993; 88: Wever EF, Hauer RN, van Capelle FL, Tijssen JG, Grijns HJ, Algra A, et al: Randomized study of implantable defibrillator as first-choice therapy versus conventional strategy in postinfarct sudden death survivors. Circulation 1995; 91: Fogoros RN, Fiedler SB, Elson JJ: The automatic implantable cardioverter defibrillator in drug refractory ventricular tachyarrhythmias. Ann Intern Med 1987; 107: Newman D, Sauve MJ, Herre J, Langberg JJ, Lee MA, Titus C, et al: Survival after implantation of the cardioverter defibrillator. Am J Cardiol 1992; 69: Bocker D, Haverkamp W, Block M, Borggrefe M, Hammel D, Breithardt G: Comparison of d,l-sotalol and implantable defibrillators for treatment of sustained ventricular tachycardia or fibrillation in patients with coronary artery disease. Circulation 1996; 94: Zipes DP, Wellens HJJ: Sudden cardiac death. Circulation 1998; 98 : Viskin S, Belhassen B: Polymorphic ventricular tachyarrhythmias in the absence of organic heart disease: classification, differential diagnosis, and implication for therapy. Prog cardiovasc Dis 1998; 41: Wever EF, Hauer RN, Oomen A, Peters RH, Bakker PF, Robles de Medina EO, et al: Unfavorable outcome in patients with primary electrical disease who survived an episode of ventricular fibrillation. Circulation 1993; 88: Wellens HJ, Lemery R, Smeets JL, Brugada P, Gorgels AP, Cheriex EC, et al: Sudden arrhythmic death without overt heart disease. Circulation 1992; 85(Suppl 1): I Breithardt G, Wichter T, Haverkamp W, Borggrefe M, Block M, Hammel D, et al: Implantable cardioverter defibrillator therapy in patients with arrhythmogenic right ventricular cardiomyopathy, long QT syndrome, or no structural heart disease. Am Heart J 1994; 127: Pitt B: Sudden cardiac death: role of left ventricular dysfunction. Ann N Y Acad Sci 1982; 382: Bigger JT Jr: Relation between left ventricular dysfunction and ventricular arrhythmias after myocardial infarction. Am J Cardiol 1986: 57: 8B-14B. 253 Holmes J, Kubo SH, Cody RJ, Kligfield P: Arrhythmias in ischemic and nonischemic dilated cardiomyopathy: prediction of mortality by ambulatory electrocardiography. Am J Cardiol 1985; 55: Bigger JT Jr, Fleiss JL, Kleiger R, Miller JP, Rolnitzky LM: The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation 1984; 69: Buxton AE, Marchlinski FE, Waxman HL, Flores BT, Cassidy DM, Josephson ME: Prognostic factors in nonsustained ventricular tachycardia. Am J Cardiol 1984; 53: Follansbee WP, Michelson EL, Morganroth J: Nonsustained ventricular tachycardia in ambulatory patients: characteristics and association with sudden cardiac death. Ann Intern Med 1980; 92: Hofmann T, Meinertz T, Kasper W, Geibel A, Zehender M, Hohnloser S, et al: Mode of death in dilated cardiomyopathy : a multivariate analysis of prognostic determinants. Am Heart J 1988; 116: Romeo F, Pelliccia F, Cianfrocca C, Cristofani R, Reale A: Predictors of sudden death in idiopathic dilated cardiomyopathy. Am J Cardiol 1989; 63: Gianfrocca C, Pelliccia F, Nigri A, Critelli G: Resting and ambulatory ECG predictors of mode of death in dilated cardiomyopathy. J Electrocardiol 1992; 25: Matsuda N, Kasanuki H, Ohnishi S, Hidai C, Horie T, Sekiguchi M, et al: Relationship between ventricular arrhythmias, ventricular dysfunction, and sudden death in dilated cardiomyopathy ;In Sekiguchi M, Olsen EG(eds): Cardiomyopathy Update 5: Prognosis and treatment of cardiomyopathies and myocarditis. Japan, Univ Tokyo Press, 1994; p The Cardiac Arrhythmia Suppression Trial II Investigators: Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. N Engl J Med 1992; 327: Teo KK, Yusuf S, Furberg CD: Effects of prophylactic antiarrhythmic drugs therapy in acute myocardial infarction: an overview of results from randomized controlled trials. JAMA 1993; 270: Burkart F, Pfisterer M, Kiowski W, Follath F, Bruckhardt D: 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 Cardiol 1990; 16: Ceremuzynski L, Kleczar E, Krzeminska-Pakula M, Kuch J, Nartowicz E, Smielak-Korombel J, et al : Effect of amiodarone on mortality after myocardial infarction : a double-blind, placebo-controlled, pilot study. J Am Coll Cardiol 1992; 20: Cairns JA, Connolly SJ, Roberts R, Gent M for the Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators: Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations: CAMIAT. Lancet 1997; 349: Singh SN, Fletcher RD, Fisher SG, Singh BN, Lewis HD, Deedwania PC: for the Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure: Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. N Engl J Med 1995; 333: