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Multiple monomorphic ventricular tachycardia configurations predict failure of antiarrhythmic drug therapy guided by electrophysiologic study.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Mitrani, Raul David Biblo, Lee Arnold Carlson, Mark D. Gatzoylis, K. A. Henthorn, R. W. Waldo, Albert L. |
| Copyright Year | 1993 |
| Abstract | OBJECTIVES The purpose of this study was to determine whether the induction at electrophysiologic study of sustained monomorphic ventricular tachycardias with multiple QRS complex configurations predicted failure of subsequent serial electrophysiologic study guided antiarrhythmic drug testing. BACKGROUND Ventricular tachycardias with multiple QRS complex configurations are associated with failure of surgical therapy for ventricular tachycardia. As such, the presence of multiple monomorphic QRS complex ventricular tachycardias during electrophysiologic testing may predict failure of subsequent medical therapy. METHODS Fifty-one consecutive patients with coronary artery disease had reproducible induction of monomorphic ventricular tachycardia during a baseline electrophysiologic study. Each patient then underwent a mean of 1.5 antiarrhythmic drug trials. An antiarrhythmic drug regimen that suppressed induction of ventricular tachycardia was identified in 13 (26%) of the 51 patients. RESULTS Patients with only one inducible monomorphic QRS complex ventricular tachycardia at baseline study were more likely to have an antiarrhythmic drug regimen identified that suppressed inducible ventricular tachycardia than were patients with multiple monomorphic QRS complex ventricular tachycardias (12[36%] of 33 patients vs. 1 [6%] of 18, p = 0.04). In seven patients with only one induced configuration of ventricular tachycardia, a second monomorphic ventricular tachycardia with a different QRS complex configuration occurred during attempts at pacing termination of the induced ventricular tachycardia. None of these seven patients then had successful drug suppression of inducible ventricular tachycardia. Thus, 12 (46%) of 26 patients with a single monomorphic QRS complex ventricular tachycardia observed at baseline study had successful serial drug testing compared with 1 (4%) of 25 patients with multiple QRS complex ventricular tachycardia configurations (p = 0.002). CONCLUSIONS The induction or observation of multiple monomorphic QRS complex ventricular tachycardias at baseline electrophysiologic study predicted failure of subsequent serial electrophysiologic study--guided antiarrhythmic drug therapy. |
| Starting Page | 1 |
| Ending Page | 6 |
| Page Count | 6 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://core.ac.uk/download/pdf/82626631.pdf |
| PubMed reference number | 8409050v1 |
| Volume Number | 22 |
| Issue Number | 4 |
| Journal | Journal of the American College of Cardiology |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Anti-Arrhythmia Agents Arteriopathic disease BaseLine dental cement Coronary Artery Disease Monomorphic Ventricular Tachycardia by ECG Finding Patients Premature ventricular contractions Substance Abuse Detection Tachycardia, Ventricular Ventricular Fibrillation |
| Content Type | Text |
| Resource Type | Article |
