EP-guided therapy

MUSTT (NEJM 1999) EP guided therapy (antiarrhythmic drugs and ICD) vs no therapy in patients with CAD, EF < 40%, asymptomatic NSVT and inducible VT with EP study 704 39 All cause mortality reduced by 55% in ICD arm (compared to control), arrhythmic death reduced by 73% <0.001 <0.001... 

Fig. 3.3 Overall mortality rates for those receiving no anti-arrhythmic medication, EPS-guided therapy without ICD (antiarrhythmic medication), and those receiving ICD in the MUSTT study...

If inducible, randomized conservative or EP-guided therapy (conservative = j3-blocker and angiotensin converting enzyme inhibitor)... 

Capucci, A., D. Aschieri, and G.Q. VUlani, The role of EP-guided therapy in ventricular arrhythmias heta-hlockers, sotalol, and ICD s. J Interv Card Electrophysiol, 2000. 4(Suppl 1) p. 57-63. 

The Multicenter Unsustained Tachycardia Trial (MUSTT) was not designed as an ICD trial per se, but rather to test whether EP-guided antiarrhythmic therapy would decrease the risk of SCD (17). The trial enrolled patients with CAD, LVEF 40% or less, NSVT, HF class I—III, and inducible VT during EP study. NSVT had to occur four days or more post-MI or revascularization. 704 inducible patients were randomized to EP-guided... 

Fig. 4.80 A. Lead delivery system with guide catheters. Hemostatic valve, guide wires and EP catheter. Courtesy Guidant/Boston Scientific. B. Family of guide catheters with multiple distal tip curves. Courtesy Medtronic Corporation. C. Hemostatic valve and flush system. Courtesy Guidant/Boston Scientific, (from Belott PH Implantation Techniques for Cardiac resynchronization Therapy Barold SS, Mugica J Fifth Decade of Cardiac Pacing. Armonk NY Futura. 2004 pp 10)...

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