Abstract:
:Seventeen patients (16 men and 1 woman) were challenged with isoproterenol after their initially inducible sustained ventricular tachyarrhythmia (monomorphic tachycardia in 14 patients and fibrillation in 3) was completely suppressed by class I antiarrhythmic drugs. Coronary artery disease was documented in 11 patients, dilated cardiomyopathy in 2 and no structural heart disease in the remaining 4 patients. The initial presentation was aborted sudden cardiac death (five patients), syncope (eight patients) and symptomatic nonsustained ventricular tachycardia (four patients). The antiarrhythmic drug that rendered the initial ventricular tachyarrhythmias noninducible was class IA in 11 cases, class IC in 5 and combined class IA and IB in 1. The original ventricular tachyarrhythmia became reinducible in 10 patients (group A) and remained noninducible in 7 patients (group B) after isoproterenol infusion at a rate necessary to achieve a 20% increase in heart rate. Despite the results of isoproterenol challenge, all patients were maintained on their electrophysiologically guided antiarrhythmic regimen. During a mean follow-up period of 13 +/- 9 months, 3 of the 10 patients in group A experienced clinical recurrence of tachyarrhythmia; no recurrence was noted in group B. In conclusion, reinducibility of ventricular tachyarrhythmia after beta-adrenergic stimulation seems to identify a subgroup of patients at high risk of subsequent arrhythmic events. Beta-adrenergic blockade or surgical therapy may be indicated in some patients with a positive isoproterenol challenge.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Jazayeri MR,Van Wyhe G,Avitall B,McKinnie J,Tchou P,Akhtar Mdoi
10.1016/0735-1097(89)90114-9subject
Has Abstractpub_date
1989-09-01 00:00:00pages
705-11; discussion 712-4issue
3eissn
0735-1097issn
1558-3597pii
0735-1097(89)90114-9journal_volume
14pub_type
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更新日期:2015-08-04 00:00:00
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更新日期:2009-10-20 00:00:00
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更新日期:2011-08-09 00:00:00
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更新日期:2007-04-17 00:00:00
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更新日期:2006-01-03 00:00:00
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更新日期:2015-03-24 00:00:00
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更新日期:2017-08-29 00:00:00
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更新日期:2003-02-05 00:00:00