Sudden death prediction by programmed electrical stimulation following myocardial infarction.

To determine prospectively whether electrophysiologic testing is prognostically useful following a myocardial infarction, 38 patients were studied. Ventricular tachycardia was induced in 32 of 38 (84%) patients (sustained in 12) and was significantly increased with the use of three or four extrastimuli. In 17 months' mean follow-up, 4 patients died suddenly or survived an episode of sustained ventricular tachycardia. Programmed ventricular stimulation was a sensitive but not a specific predictor of these events with an overall 24% predictive accuracy. The use of one or two extrastimuli substantially improved specificity but was insensitive in predicting sudden death or ventricular tachycardia. Programmed ventricular stimulation soon after uncomplicated myocardial infarction was not a useful prognostic indicator for sudden death or subsequent ventricular tachycardia.