Abstract:
:Drug trials during electrophysiologic study were performed in 166 patients with sustained ventricular tachycardia (VT) or ventricular fibrillation. In the first 21 patients (group I), a maximum of two extrastimuli was used. In 145 subsequent patients (group II), drug efficacy was assessed using three extrastimuli if one or two failed to induce VT. The incidence of acute drug efficacy was 15 of 21 (71%) in group I, but only 44 of 145 (30%) in group II (p less than 0.01). To assess the influence of the third extrastimulus on the differing incidence of acute drug efficacy, we examined the 69 group II patients whose VT was initially induced by one or two extrastimuli. Acutely effective agents were identified for 19 of these 69 patients using up to three extrastimuli to define efficacy. In 24 of te 50 patients for whom no effective drug could be found, VT was induced with one or two extrastimuli during all drug trials. In the remaining 26 patients VT could be induced after drug administration only with use of three extrastimuli. If efficacy had been defined using a maximum of two extrastimuli, these 26 patients would have been considered responsive to drug testing. Overall, 45 to 69 (65%) rather than 19 of 69 (28%) would have had a favorable response (p less than 0.001). Fourteen group I patients and 17 group II patients in whom VT was initially induced by one or two extrastimuli received chronic therapy with agents predicted effective during acute drug trials. At 18 months, the cumulative percent of patients free of arrhythmia recurrence by actuarial analysis was 79 +/- 14% in group I and 80 +/- 14% in group II (NS). Use of three extrastimuli during drug trials is associated with a lower incidence of acute drug efficacy. Limited data suggest that prophylaxis against VT induction by three, rather than two, extrastimuli may not be a stronger predictor of chronic efficacy in patients whose VT is initially induced by one or two extrastimuli. Further study is needed to identify optimal pacing methods for antiarrhythmic drug assessment.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Swerdlow CD,Blum J,Winkle RA,Griffin JC,Ross DL,Mason JWdoi
10.1016/0002-8703(82)90432-xsubject
Has Abstractpub_date
1982-11-01 00:00:00pages
1004-11issue
5 Pt 1eissn
0002-8703issn
1097-6744pii
0002-8703(82)90432-Xjournal_volume
104pub_type
杂志文章abstract:BACKGROUND:Patients undergoing percutaneous coronary intervention (PCI) for unstable coronary syndromes have substantial emotional and spiritual distress that may promote procedural complications. Noetic (nonpharmacologic) therapies may reduce anxiety, pain and distress, enhance the efficacy of pharmacologic agents, or...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2001.119138
更新日期:2001-11-01 00:00:00
abstract::One hundred thirty-three patients with dilated heart failure, 80 with coronary artery disease, and 53 with idiopathic dilated cardiomyopathy were followed for a mean of 29 months. Patients with ischemic heart disease had a worse prognosis than those classified as having idiopathic cardiomyopathy. Features from history...
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pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-09-01 00:00:00
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pub_type: 杂志文章,meta分析
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更新日期:1992-02-01 00:00:00
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更新日期:1981-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-8703(92)91028-y
更新日期:1992-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90462-7
更新日期:1996-12-01 00:00:00
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更新日期:1985-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-8703(87)90724-1
更新日期:1987-03-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2019-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:1978-03-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.09.007
更新日期:2005-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.ahj.2009.06.025
更新日期:2009-09-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2007.02.031
更新日期:2007-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.ahj.2014.05.004
更新日期:2014-08-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2010-07-01 00:00:00
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,多中心研究
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更新日期:1998-09-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:1993-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:1976-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:1982-11-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2016-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:1993-02-01 00:00:00
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pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2012.11.008
更新日期:2013-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2008-01-01 00:00:00