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Electrophysiologic assessment of antiarrhythmic drug efficacy for ventricular tachyarrhythmias associated with dilated cardiomyopathy


, : Electrophysiologic assessment of antiarrhythmic drug efficacy for ventricular tachyarrhythmias associated with dilated cardiomyopathy. American Journal of Cardiology 59(4): 291-295

To determine the benefit of serial electrophysiologic drug testing in patients with ventricular tachyarrhythmias related to dilated cardiomyopathy, programmed ventricular stimulation was performed in 38 patients. In the baseline study, sustained ventricular tachycardia (VT) was induced in 18 patients, ventricular fibrillation in 7 and nonsustained VT in 13. The patients underwent a total of 84 trials of drug therapy (mean 2.3 .+-. 1.4 trials/patient). Complete success (induction of fewer than 6 repetitive responses) was recorded in 19 trials and partial success (induction of at least 6 but no more than 15 repetitive responses) in 7. Potential proarrhythmic effects were observed in 9 trials. Overall, at least 1 successful regimen was identified for 20 patients (53%). During a mean follow-up of 21 .+-. 13 months, there were no arrhythmia recurrences or episodes of sudden death among patients discharged with a drug regimen determined to be effective by serial drug testing. In comparison, among patients taking regimens that failed to prevent arrhythmia induction, there were 3 arrhythmia recurrences and 2 sudden deaths (p < 0.05). Serial electrophysiologic drug testing provides an effective method of identifying successful medical therapy for patients with ventricular arrhythmia related to dilated cardiomyopathy.

Accession: 005349258

PMID: 3544793

DOI: 10.1016/0002-9149(87)90801-0

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Related references

Mason, J.W., 1993: A comparison of electrophysiologic testing with Holter monitoring to predict antiarrhythmic-drug efficacy for ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. Invasive electrophysiologic study and noninvasive Holter monitoring (in conjunction with exercise testing) have both been used to evaluate the efficacy of antiarrhythmic drugs in patients with sustained ventricular tachycardia and in survivors of...

Mason, Jay W., 1993: A comparison of electrophysiologic testing with Holter monitoring to predict antiarrhythmic-drug efficacy for ventricular tachyarrhythmias. Background: Invasive electrophysiologic study and noninvasive Holter monitoring (in conjunction with exercise testing) have both been used to evaluate the efficacy of antiarrhythmic drugs in patients with sustained ventricular tachycardia and in s...

Rae A.P.; Greenspan A.M.; Spielman S.R.; Sokoloff N.M.; Webb C.R.; Kay H.R.; Horowitz L.N., 1985: Antiarrhythmic drug efficacy for ventricular tachyarrhythmias associated with coronary artery disease as assessed by electrophysiologic studies. The efficacy and proarrhythmic potential of antiarrhythmic agents were evaluated. Programmed ventricular stimulation was performed in 160 consecutive patients with coronary artery disease during a baseline study and 432 subsequent drug studies. Th...

Poll, D.S.; Marchlinski, F.E.; Buxton, A.E.; Doherty, J.U.; Waxman, H.L.; Josephson, M.E., 1984: Sustained ventricular tachycardia in patients with idiopathic dilated cardiomyopathy: electrophysiologic testing and lack of response to antiarrhythmic drug therapy. Consecutive patients (11) with idiopathic dilated cardiomyopathy and spontaneous, sustained ventricular tachycardia (VT) of uniform morphology underwent programmed ventricular stimulation and serial antiarrhythmic drug testing. The mean ejection f...

Liem L.B.; Ovadia M.; Sasson Z.; Franz M.R.; Swerdlow C.D., 1987: Value of electrophysiologic study in patients with idiopathic dilated cardiomyopathy and sustained ventricular tachyarrhythmias. Journal of the American College of Cardiology 9(2 SUPPL A): 107A

Milner P.G.; Lerman B.B.; Dimarco J.P., 1985: Role of electrophysiologic testing in patients with idiopathic dilated cardiomyopathy and ventricular tachyarrhythmias. American Heart Association Monograph (114): III-159

Desseigne P.; Saoudi N.; Pham E.; Atallah G.; Kirkorian G.; Touboul P., 1990: Malignant ventricular arrhythmias in dilated cardiomyopathy limited efficacy of empiric antiarrhythmic drug therapy. European Heart Journal 11(ABSTR SUPPL): 3

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