Abstract:
BACKGROUND:Antiarrhythmic drugs are still used for the treatment of ventricular tachyarrhythmias, in combination with implantable cardioverter-defibrillators or without them. AIM OF THE STUDY:In a double-blind randomized crossover design, the short- and long-term efficacy and safety of oral dofetilide or oral sotalol were compared in 135 patients with ischaemic heart disease and inducible sustained ventricular tachycardia. METHODS:The inducibility of ventricular tachycardia was determined by programmed electrophysiological stimulation at baseline. Patients were then blindly randomized to receive either oral dofetilide 500 microg twice daily or oral sotalol 160 mg twice daily, for 3 to 5 days. Suppression of inducible ventricular tachycardia on the drug was then assessed by programmed electrophysiological stimulation. After a wash-out period of at least 2.5 days, the patients received the alternative treatment for 3 to 5 days. Suppression of inducible ventricular tachycardia on the alternate drug was again determined by programmed electrophysiological stimulation. Selection of long-term treatment was allocated blindly according to programmed electrophysiological stimulation results. RESULTS:During the acute phase, 128 patients received both dofetilide and sotalol. Sixty-seven patients were responders to either drug. Forty-six patients (35.9%) were responders to dofetilide compared with 43 (33.6%) to sotalol (P=ns). Only 23 patients responded to both dofetilide and sotalol. Adverse events, deemed to be treatment related, were seen in 2.3% of patients receiving dofetilide and 8.6% of patients receiving sotalol (P=0.016). Three patients on dofetilide had torsade de pointes. Two patients receiving sotalol died during the acute phase (one was arrhythmic death, and the other was due to heart failure). During the long-term phase, two of 42 patients (4.8%) receiving dofetilide and three of 27 patients (11.1%) receiving sotalol withdrew from treatment due to lack of efficacy. Overall, during the long-term phase, 23.8% of the patients receiving dofetilide and 37.0% of the patients receiving sotalol, withdrew from treatment with a similar pattern of withdrawals for the two drugs. CONCLUSION:Dofetilide was as efficacious as sotalol in preventing the induction of sustained ventricular tachycardia. There was no concordance in the response rate in two-thirds of the patients. Dofetilide was significantly better tolerated during the acute phase than sotalol. Both dofetilide and sotalol were well tolerated during the long term with no statistically significant difference in the adverse events.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Boriani G,Lubinski A,Capucci A,Niederle R,Kornacewicz-Jack Z,Wnuk-Wojnar AM,Borggrefe M,Brachmann J,Biffi M,Butrous GS,Ventricular Arrhythmias Dofetilide Investigators.doi
10.1053/euhj.2001.2679subject
Has Abstractpub_date
2001-12-01 00:00:00pages
2180-91issue
23eissn
0195-668Xissn
1522-9645pii
S0195668X0192679Xjournal_volume
22pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract:AIM:Heart disease is recognized as a consequence of dysregulation of cardiac gene regulatory networks. Previously, unappreciated components of such networks are the long non-coding RNAs (lncRNAs). Their roles in the heart remain to be elucidated. Thus, this study aimed to systematically characterize the cardiac long no...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehu180
更新日期:2015-02-07 00:00:00
abstract::Approximately 20% of patients undergoing diagnostic coronary arteriography for acute or chronic cardiac ischaemia have angiographically normal coronary arteries. The mechanism behind this phenomenon is likely to be the result of a combination of functional or anatomical abnormalities in the coronary microcirculation, ...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/17.suppl_g.14
更新日期:1996-12-01 00:00:00
abstract:AIMS:There is little evidence to inform routine practice in the use of coronary angiography and revascularization procedures after acute myocardial infarction. Large differences in the uptake of these procedures have been reported but representative data are scarce. Outcome studies have produced opposing conclusions co...
journal_title:European heart journal
pub_type: 杂志文章,meta分析
doi:10.1053/euhj.1998.1027
更新日期:1998-09-01 00:00:00
abstract::The duration of the reduction of mortality after coronary artery bypass grafting (CABG) is an important issue and this study was undertaken to evaluate time in relation to excess mortality among CABG patients compared with the general population. Survival was analysed in 4661 patients who had undergone their first iso...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060654
更新日期:1994-09-01 00:00:00
abstract::Early treatment with ACE inhibitors of even moderate heart failure is clinically beneficial, even though haemodynamic measurements cannot adequately quantitate such improvement. Neurohumoral assessment is, however, supposed to be more accurate. In 55 patients with moderate heart failure (ejection fraction < or = 35%),...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/eurheartj/15.suppl_d.113
更新日期:1994-12-01 00:00:00
abstract:AIMS:In mechanical heart valve recipients, low-dose international normalized ratio (INR) self-management of oral anticoagulants can reduce the risk of developing thrombo-embolic events and improve long-term survival compared with INR control by a general practitioner. Here, we present data on the safety of low-dose INR...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehm391
更新日期:2007-10-01 00:00:00
abstract::Myocardial bridging of the left anterior descending coronary artery producing complete systolic occlusion was demonstrated in a patient with hypertrophic cardiomyopathy, who had localized myocardial hypertrophy in the lateral left ventricular wall outside the territory of that artery. Although a cause and effect relat...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/8.7.793
更新日期:1987-07-01 00:00:00
abstract:AIMS:To determine the prevalence, incidence rate, lifetime risk and prognosis of heart failure. METHODS AND RESULTS:The Rotterdam Study is a prospective population-based cohort study in 7983 participants aged > or =55. Heart failure was defined according to criteria of the European Society of Cardiology. Prevalence wa...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/j.ehj.2004.06.038
更新日期:2004-09-01 00:00:00
abstract::Increased levels of low density lipoprotein (LDL) cholesterol and triglyceride, and low levels of high density lipoprotein (HDL) cholesterol, are associated with increased risk of coronary heart disease (CHD). Only a minor part of the variation in lipids can be explained by defects in single genes of large effect; the...
journal_title:European heart journal
pub_type: 杂志文章
doi:
更新日期:1998-04-01 00:00:00
abstract:AIMS:Aortic stenosis causes cardiac hypertrophy and fibrosis, which often persists despite pressure unloading after aortic valve replacement. The persistence of myocardial fibrosis in particular leads to impaired cardiac function and increased mortality. We investigated whether granulocyte colony-stimulating factor (G-...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehr434
更新日期:2012-03-01 00:00:00
abstract:Aims:Despite the well-defined association of high-sensitivity hsCRP with cardiovascular outcomes in apparently healthy adults and those with acquired heart disease, the relevance of this inflammatory marker in adults with congenital heart disease (ACHD) remains unclear. We aimed to examine the clinical correlates and p...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehy362
更新日期:2018-09-07 00:00:00
abstract::The optimal length of clopidogrel therapy in patients with acute coronary syndromes or in those who have undergone percutaneous coronary intervention (PCI) remains controversial. We therefore sought to determine the risk of both perioperative and premature discontinuation of clopidogrel. PubMed and EMBASE databases we...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehr141
更新日期:2011-10-01 00:00:00
abstract:AIMS:Hitherto, sudden cardiac death in children (SCDc)-defined as sudden cardiac death (SCD) in the 1-18 years old-has been incompletely described in the general population. Knowledge on incidence rates, causes of death and symptoms prior to death is sparse and has been affected by reporting and referral bias. METHODS...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/eht509
更新日期:2014-04-01 00:00:00
abstract::The haemodynamic effects on the peripheral vascular bed of L-acetylcarnitine, L-propionylcarnitine, and nitroglycerin were tested by echo-Doppler in a double blind cross-over study. Eleven male patients suffering from peripheral arterial obliterative disease (PAOD) in the second stage of Fontaine's classification, and...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/oxfordjournals.eurheartj.a060392
更新日期:1994-10-01 00:00:00
abstract:AIMS:Cardiomyopathy produces significant mortality in patients with Friedreich ataxia (FA), a genetic disorder that produces intra-mitochondrial iron accumulation. We sought to test the hypothesis that abnormal myocardial perfusion reserve and fibrosis represent early manifestations of cardiomyopathy. METHODS AND RESU...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehq443
更新日期:2011-03-01 00:00:00
abstract::The present review summarizes the available information on the effects of the three major classes of antianginal agents (nitrates, calcium and beta-blockers) on myocardial energy metabolism. It also discusses the role of some new molecules (L-carnitine, trimetazidine and ranolazine) that have been proposed as an alter...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/14.suppl_g.2
更新日期:1993-11-01 00:00:00
abstract:AIMS:The SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK (SHOCK) Trial showed no benefit of early revascularization in patients aged >/=75 years with acute myocardial infarction and cardiogenic shock. We examined the effect of age on treatment and outcomes of patients with cardiogenic shock ...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0195-668x(02)00844-8
更新日期:2003-05-01 00:00:00
abstract:AIM:Little is known about the prognostic significance of silent versus symptomatic coronary artery disease (CAD) in diabetic patients. We therefore assessed the incidence of scintigraphic evidence of CAD in diabetic patients without known CAD and the impact of symptoms and scintigraphic findings on prognosis. METHODS ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/j.ehj.2004.02.013
更新日期:2004-04-01 00:00:00
abstract::Clinical reports show that electrical stimulation of the spinal cord reduces symptoms of angina pectoris, but so far have not provided evidence on the mechanisms involved. The hypothesis for this study was that inhibition of spinothalamic tract transmission may account for this result. Extracellular potentials of 28 s...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.1.96
更新日期:1993-01-01 00:00:00
abstract:AIMS:In acute coronary syndromes (ACS), the optimal revascularization strategy for unprotected left main coronary disease (ULMCD) has been little studied. The objectives of the present study were to describe the practice of ULMCD revascularization in ACS patients and its evolution over an 8-year period, analyse the pro...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehp353
更新日期:2009-10-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm567
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Mortality from cardiac surgery is an essential indicator of quality and forms the basis of treatment strategy decisions in eligible patients. No contemporary complete data on unselected adult cardiac surgery patients are available in Germany. METHODS AND RESULTS:A registry was started in June 1997 of all pa...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1999.1634
更新日期:2000-01-01 00:00:00
abstract::The antibody prevalence data indicate that C. pneumoniae infections are common worldwide and more frequently occur in middle-aged and elderly males than in females. C. pneumoniae infections are first acquired in childhood in heavily populated areas, whereas in northern countries, first infections are generally at teen...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:
更新日期:1993-12-01 00:00:00
abstract::Opiate agonists were administered into the cisterna magna of normotensive urethane-anaesthetized artificially-ventilated rats. Increases in blood pressure and heart rate were produced by fentanyl (0.3-3.0 nmol). [D-ala]2-met-enkephalinamide (17 nmol), and beta-endorphin (2.9 nmol). On the contrary, ethylketocyclazocin...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/4.suppl_g.61
更新日期:1983-11-01 00:00:00
abstract:BACKGROUND:Myocardial ischaemia occurs principally in the subendocardial layer, whereas conventional myocardial perfusion imaging provides no information on the transmural myocardial blood flow (MBF) distribution. Subendocardial perfusion measurements and quantification of the transmural perfusion gradient (TPG) could ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehu170
更新日期:2014-08-14 00:00:00
abstract::There is mounting evidence to support the influence of inflammation in the pathogenesis of atrial fibrillation (AF). Indeed, AF is associated with increased levels of known inflammatory markers, even after adjustment for confounding factors. The renin-angiotensin-aldosterone system (RAAS) appears to play a key role in...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehi645
更新日期:2006-01-01 00:00:00
abstract::Thrombolytic treatment efficacy is greater when the delay between onset of pain and treatment is short. One way to shorten this delay is to give treatment at home, but one cannot recommend this technique if it has not been demonstrated first, that pre-hospital thrombolysis is feasible and safe, and second, that it is ...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/11.suppl_f.43
更新日期:1990-08-01 00:00:00
abstract::In order to assess the value of pulsed Doppler echocardiography in detection of valvular regurgitation, 63 patients were evaluated for aortic and/or mitral regurgitation using pulsed Doppler echocardiography and selective cineangiography. The Doppler study was considered as positive when a turbulent flow was detected ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061674
更新日期:1984-05-01 00:00:00
abstract::The understanding of atrial fibrillation (AF) evolved from a sole rhythm disturbance towards the complex concept of a cardiomyopathy based on arrhythmia substrates. There is evidence that atrial fibrosis can be visualized using late gadolinium enhancement cardiac magnetic resonance imaging and that it is a powerful pr...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehz786
更新日期:2020-03-07 00:00:00
abstract::The fundamental abnormality in syndrome X (angina pectoris, ischaemia-like stress ECG despite angiographically normal coronary arteries) might be patchily distributed increased tone in pre-arteriolar coronary vessels with compensatory release of adenosine. The aim of this study was to confirm this hypothesis and to ex...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060780
更新日期:1995-11-01 00:00:00