| Use of nonsustained ventricular tachycardia as a guide to antiarrhythmic drug therapy in patients with malignant ventricular arrhythmia. | |
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MedLine Citation:
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PMID: 6823797 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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From a population of 260 patients with malignant ventricular arrhythmia (ventricular fibrillation or ventricular tachycardia with syncope) we identified 52 (20%) who had infrequent ventricular premature beats during exercise testing and 48 hours of ambulatory monitoring. These patients underwent invasive electrophysiologic study utilizing programmed premature stimulation with up to three extrastimuli at currents of twice and three times middiastolic threshold. The end point for testing was nonsustained ventricular tachycardia (NSVT), defined as 3 to 20 propagated responses resulting from the last premature stimulus. A multiple response was obtained in 45 patients consisting of reproducible NSVT in 36 and sustained ventricular tachycardia in nine. The 36 patients with NSVT underwent 540 electrophysiologic tests with 18 antiarrhythmic agents. Suppression of the repetitive response was achieved in 31 of the 36 patients (86.1%). After an average follow-up of 21 months, one of 31 patients in whom the repetitive response had been abolished had recurrent arrhythmia. This contrasted with recurrence in two of the five patients in whom NSVT was still provoked. During the extensive testing, ventricular fibrillation was not induced. Sustained ventricular tachycardia occurred in 27 of the 540 tests (5.0%), but cardioversion was required in only 12 (2.2%). We conclude that NSVT constitutes a safe electrophysiologic end point for selecting an effective antiarrhythmic program in patients who have experienced malignant ventricular arrhythmia but in whom monitoring and exercise testing are inadequate to guide therapy. |
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Authors:
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P J Podrid; A Schoeneberger; B Lown; S Lampert; J Matos; J Porterfield; E Raeder; E Corrigan |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: American heart journal Volume: 105 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1983 Feb |
Date Detail:
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Created Date: 1983-03-11 Completed Date: 1983-03-11 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 181-8 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Anti-Arrhythmia Agents / therapeutic use Cardiac Pacing, Artificial* Female Heart Ventricles Humans Male Middle Aged Tachycardia / diagnosis*, drug therapy Ventricular Fibrillation / diagnosis*, drug therapy |
| Grant Support | |
ID/Acronym/Agency:
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HL-07776/HL/NHLBI NIH HHS; HL-18783/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anti-Arrhythmia Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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