Abstract:
OBJECTIVES:The aim of this study was to evaluate the survival of patients with hypertrophic cardiomyopathy (HCM) after resuscitated ventricular fibrillation or syncopal sustained ventricular tachycardia (VT/VF) when treated with low dose amiodarone or implantable cardioverter defibrillators (ICDs). BACKGROUND:Prospective data on clinical outcome in patients with HCM who survive a cardiac arrest are limited, but studies conducted before the widespread use of amiodarone and/or ICD therapy suggest that over a third die within seven years from sudden cardiac death or progressive heart failure. METHODS:Sixteen HCM patients with a history of VT/VF (nine male, age at VT/VF 19 +/- 8 years [range 10 to 36]) were studied. Syncopal sustained ventricular tachycardia/ventricular fibrillation occurred during or immediately after exertion in eight patients and was the initial presentation in eight. One patient had disabling neurologic deficit after VT/VF. Before VT/VF, two patients had angina, four had syncope and six had a family history of premature sudden cardiac death. After VT/VF all patients were in New York Heart Association class I or II, three had nonsustained VT during ambulatory electrocardiography and 11 had an abnormal exercise blood pressure response. After VT/VF eight patients were treated with low dose amiodarone and six received an ICD. Prophylactic therapy was declined by two patients. RESULTS:Mean follow-up was 6.1 +/- 4.0 years (range 0.5 to 14.5). Cumulative survival (death or ICD discharge) for the entire cohort was 59% at five years (95% confidence interval: 33% to 84%). Thirteen (81%) patients were alive at last follow-up. Two patients died suddenly while taking low dose amiodarone, and one died due to neurologic complications of his initial cardiac arrest. Three patients had one or more appropriate ICD discharges during follow-up; the times to first shock after ICD implantation were 23, 197 and 1,124 days. CONCLUSIONS:This study shows that patients with HCM who survive an episode of VT/VF remain at risk for a recurrent event. Implantable cardioverter defibrillator therapy appears to offer the best potential benefit regarding outcome.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Elliott PM,Sharma S,Varnava A,Poloniecki J,Rowland E,McKenna WJdoi
10.1016/s0735-1097(99)00056-xsubject
Has Abstractpub_date
1999-05-01 00:00:00pages
1596-601issue
6eissn
0735-1097issn
1558-3597pii
S0735-1097(99)00056-Xjournal_volume
33pub_type
杂志文章abstract:OBJECTIVES:The purpose of this study is to describe the outcome in cardiogenic shock treated with aggressive reperfusion therapy and to identify factors predictive of in-hospital and long-term mortality. BACKGROUND:Cardiogenic shock is the most common cause of death in patients admitted to the coronary care unit. Alth...
journal_title:Journal of the American College of Cardiology
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pub_type: 杂志文章,多中心研究
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abstract::For 40 years the American College of Cardiology has been a responsible organization in promoting the art and science of cardiac care for people of all ages. This review chronicles the leapfrogging of medical and surgical creativity and contributions to saving lives and making those lives healthy through informed care ...
journal_title:Journal of the American College of Cardiology
pub_type: 历史文章,杂志文章,评审
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abstract::Doppler echocardiographic determination of the pulmonary to systemic blood flow (Qp/Qs) ratio requires calculation of pulmonary artery and aortic luminal areas and integrals of the Doppler systolic velocity curves. To simplify the Doppler calculation of the Qp/Qs ratio, the square of the ratio of pulmonary to aortic l...
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abstract::A new, predominantly single chain preparation of recombinant tissue-type plasminogen activator was evaluated to determine coronary thrombolytic efficacy in 100 patients with acute myocardial infarction. At 3.6 +/- 1.2 hours (mean +/- SD) from symptom onset, patients received either intravenous tissue plasminogen activ...
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1987-06-01 00:00:00
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更新日期:1987-06-01 00:00:00
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更新日期:2003-06-18 00:00:00
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更新日期:1994-11-01 00:00:00
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更新日期:1998-07-01 00:00:00
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更新日期:2007-07-24 00:00:00
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更新日期:2009-12-01 00:00:00
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pub_type: 杂志文章,meta分析
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更新日期:2018-06-05 00:00:00
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更新日期:2001-05-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2001-04-01 00:00:00
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更新日期:2016-10-04 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the immediate and follow-up results of percutaneous transatrial mitral commissurotomy in 600 patients with rheumatic mitral stenosis. BACKGROUND:Percutaneous transatrial mitral commissurotomy has emerged as an effective nonsurgical technique for patients with sympto...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)90374-3
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVES:We sought to test the hypothesis that complex fractionated electrograms (CFAEs) recorded during atrial fibrillation (AF) could be used as target sites for catheter ablation of AF. BACKGROUND:Mapping of AF in humans has shown that areas of CFAEs correlate with areas of slowed conduction and pivot points of r...
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doi:10.1016/j.jacc.2003.12.054
更新日期:2004-06-02 00:00:00
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更新日期:2002-09-18 00:00:00