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Predictive Value of Ventricular Arrhythmia Inducibility for Subsequent Ventricular Tachycardia or Ventricular Fibrillation in Multicenter Automatic Defibrillator Implantation Trial (MADIT) II Patients

James P. Daubert, MD^_*,_*, Wojciech Zareba, MD, PhD^_*, W. Jackson Hall, PhD, Claudio Schuger, MD, Andrew Corsello, MD, Angel R. Leon, MD^||, Mark L. Andrews, MS^_*, Scott McNitt, MS^_*, David T. Huang, MD^_*, Arthur J. Moss, MD^_* for the MADIT II Study Investigators

^_* Cardiology Unit, Department of Medicine, University of Rochester Medical Center, Rochester, New York
Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York
Department of Medicine, Henry Ford Health System, Detroit, Michigan
Maine Medical Center, Portland, Maine
^|| Department of Medicine, Emory University/Crawford Long Hospital, Atlanta, Georgia

View larger version (17K): [in a new window]   Figure 1 Cumulative probability of first appropriate therapy for (A) ventricular tachycardia (VT) or ventricular fibrillation (VF); (B) VT only; and (C) VF only in patients with and without inducible arrhythmias according to standard definition of inducibility. Determination of p values was from the log rank test.

View larger version (17K): [in a new window]   Figure 2 Cumulative probability of first appropriate therapy for (A) ventricular tachycardia (VT) or ventricular fibrillation (VF); (B) VT only; and (C) VF only in patients with and without inducible arrhythmias according to narrow definition of inducibility. Determination of p values was from the log rank test.

View larger version (18K): [in a new window]   Figure 3 Cumulative probability of first therapy for ventricular tachycardia (VT) in relationship to cycle length of induced VT. The cycle length of induced VT is divided at median value of 240 ms. The induction of a slower VT (240 ms) was more predictive of the subsequent clinical occurrence of VT than the induction of rapid VT (<240 ms), or noninducibility (solid line).

View larger version (21K): [in a new window]   Figure 4 The cumulative probability of (A) mortality and (B) combined end point of ventricular tachycardia or ventricular fibrillation or death in patients with and without inducible tachyarrhythmias according to standard definition of inducibility.

View larger version (22K): [in a new window]   Figure 5 The cumulative probability of the composite end point of appropriate implantable cardioverter-defibrillator (ICD) therapy for ventricular tachycardia (VT), appropriate ICD therapy for ventricular fibrillation (VF), or sudden death for inducible versus noinducible patients using (A) the standard definition and (B) the narrow definition.

View larger version (22K): [in a new window]   Figure 6 Cumulative probability of first appropriate therapy for either ventricular tachycardia (VT) or ventricular fibrillation (VF) in patients with and without inducible arrhythmias according to standard definition of inducibility in (A) patients with QRS <0.12 s and (B) patients with QRS 0.12 s. Determination of p values was from the log rank test.