Document Detail


Pharmacological stress testing of the His-Purkinje system in patients with bifascicular block.
MedLine Citation:
PMID:  9793094     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This literature review, based mainly on the English-language literature, focuses on pharmacological stress testing of the His-Purkinje system as part of an invasive electrophysiological study. The main target group for this investigation is patients with bifascicular block and syncope in which intermittent high grade AV block is suspected. Several drugs have been used for this purpose, mainly Class I antiarrhythmic agents such as ajmaline, procainamide, disopyramide, and flecainide. Most studies, unfortunately, suffer from limited patient numbers, lack of adequate control groups, and/or adequate follow-up. The sensitivity of the disopyramide stress test has been shown to be 75%-100% for prediction of impending high grade AV block. The specificity was > 90%. Studies on procainamide have shown a sensitivity of 60% but the specificity has not been assessed. There are no studies allowing a strict comparison of the diagnostic value of pharmacological provocation with different drugs. Based on the similarities of the electrophysiological effects on the His-Purkinje system of the above Class I agents, it is reasonable to assume that all of them might be of diagnostic value in the present clinical context, provided atrial and ventricular stimulation after drug is included in the protocol.
Authors:
A Englund; L Bergfeldt; M Rosenqvist
Related Documents :
16231954 - Drugs, qtc interval prolongation and final ich e14 guideline : an important milestone w...
14677664 - Amiodarone: guidelines for use and monitoring.
7642874 - Mexiletine antagonizes effects of sotalol on qt interval duration and its proarrhythmic...
12114844 - Non-invasive characteristics of atrial fibrillation: the value of holter recordings for...
18474274 - Natural products as a robust source of new drugs and drug leads: past successes and pre...
8865314 - Pectin/ethylcellulose film coating formulations for colonic drug delivery.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  21     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1998 Oct 
Date Detail:
Created Date:  1998-12-21     Completed Date:  1998-12-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1979-87     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Anti-Arrhythmia Agents / diagnostic use*
Bundle of His / drug effects*,  physiopathology
Cardiac Pacing, Artificial
Electrophysiology
Heart Block / diagnosis*,  physiopathology
Humans
Purkinje Fibers / drug effects*,  physiopathology
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents

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


Previous Document:  Anatomy-guided linear atrial lesions for radiofrequency catheter ablation of atrial fibrillation.
Next Document:  Pacemaker-mediated polymorphic ventricular tachycardia.