Document Detail

Antiarrhythmic drug efficacy for ventricular tachyarrhythmias associated with coronary artery disease as assessed by electrophysiologic studies.
MedLine Citation:
PMID:  3890509     Owner:  NLM     Status:  MEDLINE    
The efficacy and proarrhythmic potential of antiarrhythmic agents were evaluated. Programmed ventricular stimulation was performed in 160 consecutive patients with coronary artery disease during a baseline study and 432 subsequent drug studies. The tachyarrhythmias induced during baseline studies were sustained ventricular tachycardia (121 patients), ventricular fibrillation (16 patients), and symptomatic nonsustained ventricular tachycardia (23 patients). Regimens were completely successful if fewer than 6 repetitive ventricular responses were inducible during therapy and partially successful if no more than 15 repetitive ventricular responses were inducible. Procainamide and quinidine were the most successful single agents, with overall success rates of 24% and 35%, respectively. Either procainamide or quinidine combined with mexiletine was the most successful combination (overall success of 23%). Each anti-arrhythmic regimen showed a proarrhythmic potential. The incidence of proarrhythmic effects ranged from 4 to 13%, with no significant difference between regimens. In 13% of patients at least 1 regimen produced a proarrhythmic effect. Patients treated with an antiarrhythmic regimen that prevented induction of arrhythmia had significantly fewer arrhythmia recurrences than patients treated with a regimen that failed to prevent it. In conclusion, identification of an effective drug regimen is possible in 38% of patients with lethal ventricular arrhythmias, proarrhythmic effects occur in a significant number of patients during electrophysiologic testing of antiarrhythmic regimens, and the clinical outcome in patients in whom ventricular arrhythmias are not inducible with ventricular stimulation have a better prognosis than those in whom arrhythmias continue to be inducible on therapy.
A P Rae; A M Greenspan; S R Spielman; N M Sokoloff; C R Webb; H R Kay; L N Horowitz
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  55     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1985 Jun 
Date Detail:
Created Date:  1985-07-25     Completed Date:  1985-07-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1494-9     Citation Subset:  AIM; IM    
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MeSH Terms
Anti-Arrhythmia Agents / therapeutic use*
Clinical Trials as Topic
Coronary Disease / complications*,  physiopathology
Electric Stimulation
Middle Aged
Tachycardia / complications,  drug therapy*,  physiopathology
Reg. No./Substance:
0/Anti-Arrhythmia Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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