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Left ventricular (LV) ejection fraction (EF) alone has a limited ability to predict occurrence of ventricular tachyarrhythmias (VTs) among patients with severely reduced LVEF. LV dyssynchrony (LVD) has been reported in patients with severely reduced LVEF, and can be reliably assessed using Phase Analysis (PA) of gated single photon emission tomography (GSPECT) images. The association between LVD and VTs has not been well studied.
We identified 128 patients (106 men; mean age: 63 + 14 years; mean LVEF 23 + 7), who received an implantable cardioverter defibrillator (ICD) for primary prevention of sudden cardiac death and underwent a GSPECT study prior to ICD implantation. PA of the GSPECT images was performed using the SyncToolTM software (Syntermed, Inc., Atlanta, GA). LVD was defined as phase histogram bandwidth or phase standard deviation >2 standard deviations above the mean normal published values. Occurrence of VTs was determined through ICD interrogations and medical records.
LVD was present in 90 (70%) patients. VTs occurred in 25 (20%) patients, all of whom had LVD and none in those without LVD (figure). In a multivariable logistic analysis, summed rest score (OR, 95% CI: 1.07, 1.02-1.10), LV end-diastolic volume (1.01, 1.00-1.20) and female gender (0.03, 0.01-0.32) were independent predictors of LVD. LVEF, QRS duration or presence of a left bundle branch block did not predict LVD.
LVD assessment by GSPECT is highly predictive of VTs in patients with low LVEF.
West, Room 3001
Sunday, March 10, 2013, 11:00 a.m.-11:15 a.m.
Session Title: Nuclear Cardiology and PET: Pushing the Boundaries
Abstract Category: 21. Imaging: Nuclear
Presentation Number: 926-4
- 2013 American College of Cardiology Foundation