الفهرس 
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Abstract
Sudden cardiac death (SCD) is an important cause of mortality worldwide. because SCD is most often associated with coronary heart disease, A variety of risk stratification tools have been investigated, although the optimal strategy remains unknown. Identification of the arrhythmogenic substrate and treatment of ventricular arrhythmias in these subgroups can be challenging.
The aim of our study was to evaluate the utility of ventricular premature burden detected by ambulatory electrocardiographic monitoring (Holter ECG) in patients with ischemic cardiomyopathy for short term risk assessment of lethal ventricular arrhythmias.
Sixty patients with ischemic cardiomyopathy were followed up for 6 months for the risk of sudden death, ventricular tachycardia, syncope, DC shock (hemodynamically unstable ventricular tachycardia) & the need for electrophysiological study and ablation.
Selected patients were subjected to thorough history taking and clinical examination, ECG, Echocardiography. Thereafter 24 hours Holter was done with special emphasis on Lown’s grading system.
The sixty patients included in the study where divided into two groups of thirty, thirty who did not receive cardiac devices (group A) and 30 who received cardiac devices (18 CRT (group B1) & 12 ICD (group B2)).
In our study 11.6% reached endpoints of the study (2death, 3 patients had ventricular tachycardia and 3 patients received DC) (endpoint group) and there was 3.3 % mortality.
Concerning the age and gender, there was no relation between them and the endpoints of the study with mean age of endpoint group (patients who reached endpoints)= 61.85 ± 4.67, compared to patients who completed the 6 months follow up= 63.98 ± 8.29.
Similarly NYHA class, smoking, hypertension and diabetes mellitus did not emerge as predictors of endpoints in our study.
Concerning the echocardiographic criteria it showed no differences between both groups (EP&FP).
Regarding the QRS morphology there was no relation seen between patients who completed their 6 months follow up and patients who had endpoints, however the majority of both groups had LBBB and IVCD and this could be explained by the high proportion of patients who had received CRT in our study.
On basis of Holter data, patients with higher PVC burden where at risk of endpoints in our study with a p=0.001 comparing both groups (EP&FP) with a 100% sensitivity and 98.11% specificity with a 11290 PVCs /24 hours cut off on Roc curve, also regarding the PVCs couplet, VT runs and Lown’s grade, all showed strong predictive value of endpoints with (p<0.0175, p<0.0008, p<0.04 respectively).