| Autor: |
Trusz-Gluza, Maria, Giec, Leszek, Dąbrowski, Andrzej, Kuch, Jerzy, Pasyk, Stanisław, Piwowarska, Wiestława, Pracka, Halina, Sadowski, Zygmunt, Wodniecki, Jan |
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| Zdroj: |
Pacing & Clinical Electrophysiology; Nov1991, Vol. 14 Issue 11, p1947-1950, 4p, 1 Chart, 3 Graphs |
| Abstrakt: |
The prognostic significance of arrhythmogenic response to an antiarrhythmic drug was studied. In 782 patients with ischemic heart disease (IHD) and frequent and/or complex ventricular premature beats (VPBs), 1,041 drug tests guided by 24-hour Halter monitoring were conducted. The fallowing drags were assessed: beta blockers, disopyramide, mexiletine, amiodarone. Proarrhythmia was defined as:(1) > 4-fold increase in VPBs, (2) > 10-fold increase in repetitive forms, or (3) new occurrence of ventricular tachycardia or ventricular fibrillation (VT/VF). During a follow-up of 1-49 months (mean 22) patients were treated with antiarrhythmic drugs found to be safe in control Holter monitoring. Proarrhythmic effects were observed in 8.4% of patients. No drug was completely free of this type of reaction. In long-term observation, cardiac death and sudden death occurred in 53 and 32 patients, respectively. With actuarial analysis (Kaplan-Meier method, log-rank test) there was a significant difference in cardiac death (P < 0.011 and sudden death rate (P < 0.05) of proarrhythmia (+) compared with proarrhythmia (-) patients at 1 year (11% vs 4%, 7% vs 3%J and 3 years (24% vs 11%, 16% vs 7%), Proarrhythmic response was an independent risk factor apart from myocardial infarction, VT/VF, ejection fraction < 40% and QTc > 440 msec. Arrhythmogenic response to antiarrhythmic drugs seems to be an additional predictor of sadden death in IHD. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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