Document Detail

The effects of type I antiarrhythmic drugs on the signal-averaged electrocardiogram in patients with malignant ventricular arrhythmias.
MedLine Citation:
PMID:  1383955     Owner:  NLM     Status:  MEDLINE    
The effects of type I antiarrhythmic drugs on the signal-averaged electrocardiogram (SAECG) were analyzed in 58 patients with inducible sustained monomorphic ventricular tachycardia. SAECGs were acquired before and after drug therapy. A total of 99 drug trials were analyzed (mean 1.7 per patient). Analysis of temporal domain parameters included the duration of the QRS complex (QRSD), the high frequency total duration of the filtered QRS complex (HFTD), the duration of the signal under 40 microV (D40), initial QRS (HFTD minus D40), and the root mean square amplitude (RMSA) of the terminal 40 msec of the QRS signal. Changes in temporal parameters failed to predict drug efficacy. There were, however, type-specific drug effects on the SAECG. With the exception of type IB drugs, all drugs increased the QRSD, HFTD, and D40. Type IC drugs caused more prolongation of the QRSD and HFTD than type IA, IB, and the combination of IA+IB drugs. Prolongation of the HFTD was related to prolongation of the late potential and the initial portion of the QRS complex. A preferential effect of these drugs on the late potential was not observed. Type IC drugs also caused more prolongation of ventricular tachycardia cycle length than type IA or IB drugs. However, the increase in ventricular tachycardia cycle length did not correlate with a change in the SAECG. In summary, type I antiarrhythmic drugs cause a global slowing of ventricular activation. Although analysis of the SAECG following drug therapy was not useful for predicting drug efficacy, drug induced changes in the SAECG may be helpful for categorizing antiarrhythmic agents.
A J Greenspon; G A Kidwell; M DeCaro; S Hessen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  15     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1992 Oct 
Date Detail:
Created Date:  1992-11-25     Completed Date:  1992-11-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1445-53     Citation Subset:  IM    
Department of Medicine, Jefferson Medical College, Philadelphia, Pennsylvania.
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MeSH Terms
Anti-Arrhythmia Agents / pharmacology*,  therapeutic use
Cardiac Pacing, Artificial
Electrocardiography / methods*
Heart Conduction System / drug effects
Middle Aged
Signal Processing, Computer-Assisted*
Tachycardia, Ventricular / diagnosis,  drug therapy*,  physiopathology
Reg. No./Substance:
0/Anti-Arrhythmia Agents

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