| Natural history of potentially lethal ventricular arrhythmias in patients treated with long-term antiarrhythmic drug therapy. | |
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MedLine Citation:
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PMID: 2686388 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To examine the natural history of long-term anti-arrhythmic therapy in patients with benign and potentially lethal ventricular premature complexes (VPCs), 28 patients with initial efficacy with moricizine (greater than 75% suppression of baseline mean VPCs/hr and greater than 90% suppression of repetitive VPCs) were prospectively followed for 1 to 56 (mean +/- standard deviation 25 +/- 17) months. Patients were examined during baseline placebo, anti-arrhythmic drug therapy and intermittent pulsed-placebo reexamination periods. The mean VPCs of all patients at baseline entry were 233 +/- 47 VPCs/hr, and after moricizine therapy 14 +/- 4 VPCs/hr. Follow-up demonstrated that antiarrhythmic efficacy decreased to 75% at 12 months and to 62% at 24 months. Loss of antiarrhythmic drug efficacy most commonly occurred as a "transient" event (10 patients [36%]), and efficacy was spontaneously reestablished without a change in antiarrhythmic therapy. In contrast, increased dose titration of moricizine was necessary to reestablish antiarrhythmic suppression efficacy in 4 patients (14%), and 4 patients (14%) lost antiarrhythmic drug responsiveness during follow-up. Spontaneous decrease in baseline VPCs resulted in discontinuation of antiarrhythmic therapy in 3 patients, and increase in baseline VPCs was associated with a loss of antiarrhythmic response in 2 patients. Late proarrhythmic effects (2 patients, 7%), delayed side effects necessitating drug withdrawal (6 patients, 21%) and medical events (4 patients, 14%) occurred during 56 months of follow-up. Individual serum moricizine levels remained in the therapeutic range throughout the study and did not correlate with changes in antiarrhythmic efficacy.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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H L Kennedy; M K Sprague; S M Homan; S M Seiler; R D Wiens; D L Janosik; R M Redd; T A Buckingham |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of cardiology Volume: 64 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1989 Dec |
Date Detail:
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Created Date: 1990-01-11 Completed Date: 1990-01-11 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1289-97 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, St. Louis University Medical Center, Missouri 63110-0250. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Arrhythmia Agents
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therapeutic use* Arrhythmias, Cardiac / drug therapy*, physiopathology Drug Tolerance Evaluation Studies as Topic Humans Moricizine Phenothiazines / blood, therapeutic use Placebos Probability Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Anti-Arrhythmia Agents; 0/Phenothiazines; 0/Placebos; 31883-05-3/Moricizine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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