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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews.

Non-sustained ventricular tachycardia as a predictor of sudden cardiac death in patients with left ventricular dysfunction: a meta-analysis

Review published: 2008.

Bibliographic details: de Sousa M R, Morillo C A, Rabelo F T, Nogueira Filho A M, Ribeiro A L P.  Non-sustained ventricular tachycardia as a predictor of sudden cardiac death in patients with left ventricular dysfunction: a meta-analysis. European Journal of Heart Failure 2008; 10(10): 1007-1014. [PubMed: 18692437]

Quality assessment

This review concluded that non-sustained ventricular tachycardia was a significant predictor for arrhythmic events in patients with left ventricular dysfunction, regardless of aetiology and left ventricular ejection fraction. Although this was a generally a well-conducted review, the limitations of the available evidence may compromise the reliability of the pooled estimates Full critical summary

Abstract

BACKGROUND: Identifying patients at risk of sudden cardiac death (SCD) remains a challenge.

AIM: To evaluate the performance of non-sustained ventricular tachycardia (NSVT) from 24 hour ambulatory electrocardiography as a predictor of SCD in patients with heart failure or non-ischaemic dilated cardiomyopathy with left ventricular systolic dysfunction (LVSD).

METHODS AND RESULTS: Study search and selection were performed by independent reviewers using a validated strategy. Eleven prognostic studies with >100 patients with good quality data and multivariate analysis of predictors of SCD were included. Publication bias was evaluated by funnel plot with Kendall's tau b test. A summary ROC (sROC) curve was built to evaluate predictive performance of NSVT. There was threshold effect (Spearman's correlation between sensitivity and specificity=-0.818, p<0.01) which indicates that combining sensitivity and specificity was not appropriate. The area of 0.68+/-0.02 under the sROC curve indicates a statistically significant contribution of NSVT in the prediction of SCD. The true negative rate varied from 89 to 97%. Multivariate analysis and meta-regression suggested that the contribution of NSVT to risk stratification is independent of ejection fraction.

CONCLUSIONS: Absence of NSVT indicated a low probability of SCD in patients with LVSD. A risk score including NSVT should be evaluated in prospective studies.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

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