Document Detail


Dispersion of filtered P wave duration by P wave signal-averaged ECG mapping system: its usefulness for determining efficacy of disopyramide on paroxysmal atrial fibrillation.
MedLine Citation:
PMID:  10355923     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Although it is desirable to know drug efficacy before initiating antiarrhythmic therapy, there have been no methods for this evaluation. P wave signal-averaged ECG (P-SAECG) is useful to detect subtle changes in disturbance of atrial conduction. The purpose of this present study was to test whether P-SAECG mapping system would give any information on the efficacy of disopyramide on the prevention of paroxysmal atrial fibrillation (PAF). METHODS AND RESULTS: P-SAECG was performed before disopyramide treatment, at 3 hours after a single dose of oral disopyramide (200 mg), and after 4 weeks of disopyramide treatment (300 mg/day). After measuring the filtered P wave duration by the vector magnitude and mapping methods, we calculated filtered P wave duration dispersion, difference between the maximal and minimal filtered P wave duration within 16 chest leads at these three time points. Filtered P wave duration and filtered P wave duration dispersion before treatment were longer in 32 patients with symptomatic PAF than in 31 healthy volunteers. Disopyramide was effective for suppression of PAF in 17 patients and ineffective in 15 patients after 4 weeks of treatment. Filtered P wave duration was similarly prolonged at 3 hours in the two groups, whereas filtered P wave duration dispersion at 3 hours after the disopyramide administration behaved differently; it decreased in all of the effective group and increased in all of the ineffective group. The effective patients were prospectively followed with the same treatment for 6 months. In 16 (94%) of these 17 effective patients, no PAF was documented and they remained to be asymptomatic. CONCLUSIONS: Thus, measuring filtered P wave duration dispersion with the P-SAECG mapping method after a single administration may predict the long-term efficacy of disopyramide in patients with PAF.
Authors:
I Kubara; H Ikeda; T Hiraki; T Yoshida; M Ohga; T Imaizumi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  10     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  1999 May 
Date Detail:
Created Date:  1999-07-13     Completed Date:  1999-07-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  670-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine III and the Cardiovascular Research Institute, Kurume University School of Medicine, Japan.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adult
Aged
Anti-Arrhythmia Agents / administration & dosage,  pharmacokinetics,  therapeutic use*
Atrial Fibrillation / blood,  drug therapy,  physiopathology*
Body Surface Potential Mapping*
Disopyramide / administration & dosage,  pharmacokinetics,  therapeutic use*
Electrocardiography, Ambulatory
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prospective Studies
Tachycardia, Paroxysmal / blood,  drug therapy,  physiopathology*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 3737-09-5/Disopyramide

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


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