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Journal of Cardiovascular Medicine and Surgery

Volume  4, Issue 2, April-June 2018, Pages 118-123
 

Original Article

Etiology, Management & Outcome of Ventricular Tachycardia in Structural Heart Disease Patients in Indian Context

Tushar Nikam, Jayesh Prajapati, Shomu Bohora, Iva Patel,

1 Assistant Professor 2 Professor & Head 3 Associate Professor, Department of Cardiology, 4 Research Assistant, Department of Research, U.N. Mehta Institute of Cardiology and Research Center (Affiliated to B.J. Medical College), Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016, India

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4218.8

Abstract

Introduction: Ventricular tachycardia (VT) encompasses all the tachycardia’s originating in the ventricular myocardium or the specialized conductive tissue distal to the atrioventricular node. Structural heart disease (SHD) plays a major role in risk stratification, initial management, risk stratification, and treatment of ventricular arrhythmias.

Aim: The aim of the study was to study the clinical profile, various treatment modalities offered to patients and patient’s acceptance for same and the outcome following various treatment modalities in patients of ventricular tachycardia in structural heart disease patients in Indian context.

Materials and methods: 106 patients of ventricular tachycardia with underlying structural heart disease fulfilling the study criteria were enrolled in the study. All patients underwent detailed evaluation including history, clinical examination and laboratory investigations. Patients were managed according to standard guidelines. All patients were followed at 1 month, 3 months,and 6 months.

Results: Mean age was 53.6 years, 77.36% of patients were males. Monomorphic VT was commonest presentation and found in 93.39% of patients. Most common etiology for VT was coronary artery disease in 52.84% of patients. Mean LVEF in our study was 26.46±10.82%.Patients who had LVEF of <30% had maximum mortality of 48.05%. 23 (21.69%) patients in our study had opted for AICD and underwent the procedure accordingly. The main reason behind patients not opting for AICD was the economic issue. There were 2 (8.6%) deaths in AICD group and 12 (14.81%) in non­AICD group on follow­up.

Conclusion: In our study, the most common etiology of VT was coronary artery disease. Monomorphic VT is common in patients with underlying structural heart disease. Patients of VT with associated comorbidities and left ventricular dysfunction has higher mortality. Our study shows that the implantation of a defibrillator in patients with a prior myocardial infarction and left ventricular dysfunction, with symptomatic ventricular tachyarrhythmia have a trend towards survival benefit, compared to similar group of patients on medical follow up. But the main reason in Indian context behind not undergoing AICD implantation is economic issue.

 


Keywords : AICD; Ventricular Tachycardia.
Corresponding Author : Jayesh Prajapati, Professor & Head, Department of Cardiology, U.N. Mehta Institute of Cardiology and Research Center (Affiliated to B.J. Medical College), Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016, India.