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Proarrhythmic effects of antiarrhythmic drugs during programmed ventricular stimulation in patients without ventricular tachycardia.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Au, Patrick K. C. Bhandari, Anil K. Bream, R. C. Schreck, Daniel Siddiqi, R. A. H. Rahimtoola, Shahbudin H. |
| Copyright Year | 1987 |
| Abstract | The proarrhythmic effects of class IA antiarrhythmic drugs were prospectively evaluated during programmed ventricular stimulation in 24 consecutive patients with frequent ventricular premature beats whose baseline study, performed while no antiarrhythmic drugs were being taken, showed no inducible sustained ventricular arrhythmias. No patient had nonsustained (greater than 5 beats) or sustained ventricular tachycardia by history or baseline 24 hour ambulatory electrocardiographic monitoring. Sequential stimulation studies using up to three extra-stimuli were performed after administration of procainamide, quinidine and disopyramide on different days. Proarrhythmic response was defined as induction of one or more of the following: sustained monomorphic ventricular tachycardia; sustained polymorphic ventricular tachycardia; ventricular fibrillation; reproducibly inducible nonsustained monomorphic ventricular tachycardia. During 55 antiarrhythmic drug trials (24 of procainamide, 21 of quinidine, 10 of disopyramide) in the 24 patients, 6 patients had a proarrhythmic response: sustained monomorphic ventricular tachycardia in 3, ventricular fibrillation in 2, nonsustained monomorphic ventricular tachycardia in 1. Thus, 11% of drug trials resulted in a proarrhythmic response and 25% of patients had a proarrhythmic response to one of the drugs tested. A proarrhythmic response to one drug did not predict a similar response to another drug of the same class. The 6 patients with a proarrhythmic response did not differ significantly from the other 18 patients with regard to underlying heart disease, electrocardiographic or baseline 24 hour ambulatory electrocardiographic characteristics; however, they did have a higher incidence of digoxin usage (p less than 0.02), a shorter baseline right ventricular effective refractory period (p less than 0.01) and a smaller increment in effective refractory period during antiarrhythmic drug testing (p = 0.06).(ABSTRACT TRUNCATED AT 250 WORDS) |
| Starting Page | 307 |
| Ending Page | 318 |
| Page Count | 12 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://core.ac.uk/download/pdf/81942976.pdf |
| PubMed reference number | 2433319v1 |
| Volume Number | 9 |
| Issue Number | 2 |
| Journal | Journal of the American College of Cardiology |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Anti-Arrhythmia Agents BaseLine dental cement Digoxin Disopyramide Electrocardiography, Ambulatory Heart Diseases Increment Monomorphic Ventricular Tachycardia by ECG Finding Patients Premature Cardiac Complex Premature ventricular contractions Procainamide Quinidine Small Substance Abuse Detection Tachycardia, Ventricular Ventricular Fibrillation Ventricular arrhythmia sustained ventricular tachycardia |
| Content Type | Text |
| Resource Type | Article |
