Nonsustained ventricular tachycardia in ambulatory patients: characteristics and association with sudden cardiac death.

Thirty-seven patients with nonsustained ventricular tachycardia (greater than or equal to triplets) were identified retrospectively from a population of 518 consecutive patients referred for 24-hour Holter monitoring and studied to determine the prognostic significance of this finding. Ten of these 37 patients suffered sudden cardiac death during a mean follow-up of 19 +/- 5 months. Nine of 19 patients with a diagnosis of congestive cardiomyopathy or history of congestive heart failure died suddently compared to only one of the other 18 patients. No other patient data were predictive of sudden death. Remarkably, no characterisitc of the ventricular tachycardia including beats per episode, episodes per day, rate, prematurity index (RR1/QT) of the initiating beat, or the occurrence of associated arrhythmias was important prognostically. Thus, patients with congestive cardiomyopathy or congestive heart failure and nonsustained paroxysmal ventricular tachycardia are at a high risk for sudden death and are ideal candidates for prophylactic interventions.