Abstract:
:In patients with malignant ventricular arrhythmias, antiarrhythmic therapy is known to carry a substantial risk of proarrhythmia. This risk is usually considered to be low when supraventricular arrhythmias or benign ventricular arrhythmias are considered. We were able to collect data on four patients without a history of life-threatening arrhythmias, in whom antiarrhythmic therapy was used and resulted in documented ventricular fibrillation or torsade de pointes. In Cases No. 1 and 2, atrial fibrillation was treated with either quinidine or quinidine and sotalol in combination. In both patients Holter monitoring, 4-12 h after conversion to sinus rhythm, documented the spontaneous occurrence of torsade de pointes degenerating into ventricular fibrillation and requiring DC shock for termination. In Case No. 3, atrial fibrillation was treated with sotalol and amiodarone for 2 months when incessant episodes of torsade de pointes were documented. In Case No. 4, frequent but unsustained ventricular arrhythmias were treated with amiodarone in a patient suffering dilative cardiomyopathy. After 6 days of treatment at a heart rate of 54 beats/min, a marked QT increase was associated with the occurrence of repetitive episodes of polymorphic ventricular tachycardia degenerating into ventricular fibrillation. None of the patients presented significant electrolyte abnormalities in the laboratory. A pathologic increase of the QTc-time was documented in Cases No. 1, 3, and 4. In all patients antiarrhythmic therapy was withdrawn after the proarrhythmic event and the patient became free of malignant tachyarrhythmias. Antiarrhythmic therapy also carries a considerable risk of proarrhythmia when "benign" cardiac arrhythmias are treated. The risk seems to be lower than in patients with malignant arrhythmias, however it includes the occurrence of lethal tachyarrhythmias. Special attention should be paid to the selection of antiarrhythmic agents when used in combination.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Faber TS,Zehender M,Van de Loo A,Hohnloser S,Just Hdoi
10.1002/clc.4960170410subject
Has Abstractpub_date
1994-04-01 00:00:00pages
197-202issue
4eissn
0160-9289issn
1932-8737journal_volume
17pub_type
杂志文章abstract:BACKGROUND:Although suppression of premature ventricular contractions (PVCs) is not a predictor of mortality over the long term, the extent of PVC suppression is an important characteristic of any antiarrhythmic drug. HYPOTHESIS:This study was undertaken to determine whether intravenous (i.v.) dofetilide has the abili...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Myocardial blush grade (MBG), corrected TIMI frame count (cTFC), and ST-segment reduction are indices of myocardial reperfusion. HYPOTHESIS:We evaluated their predictive value for left ventricular (LV) function recovery by gated single-photon emission computed tomography (SPECT) after acute myocardial infar...
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更新日期:2018-11-01 00:00:00
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journal_title:Clinical cardiology
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更新日期:1990-09-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960240204
更新日期:2001-02-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
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更新日期:1984-04-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960211304
更新日期:1998-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1002/clc.4960211206
更新日期:1998-12-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2010-03-01 00:00:00
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更新日期:1999-03-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960160317
更新日期:1993-03-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2013-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2009-08-01 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:2017-12-01 00:00:00
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pub_type: 历史文章,杂志文章
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更新日期:1997-04-01 00:00:00
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更新日期:1981-09-01 00:00:00