Usefulness of electrophysiologic testing in evaluation of amiodarone therapy for sustained ventricular tachyarrhythmias associated with coronary heart disease |
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| Authors: | L N Horowitz A M Greenspan S R Spielman C R Webb J Morganroth H Rotmensch N M Sokoloff A P Rae B L Segal H R Kay |
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| Affiliation: | 1. LAQV-REQUIMTE, Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal;2. IPMA, Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, I.P.), Av. Doutor Alfredo Magalhães Ramalho 6, 1495-165, Lisboa, Portugal;3. CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Terminal de Cruzeiros do Porto de Leixões, Av. General Norton de Matos, S/N, 4450-208 Matosinhos, Portugal;4. UCIBIO-REQUIMTE, Applied Molecular Biosciences Unit, Department of Chemistry, NOVA School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal;5. MARE – Marine and Environmental Sciences Centre, Guia Marine Laboratory, Faculty of Sciences of the University of Lisbon (FCUL), Av. Nossa Senhora do Cabo, 939, 2750–374 Cascais, Portugal;6. ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Department of Population Studies, Laboratory of Ecotoxicology and Ecology (ECOTOX), Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal;1. Department of Biology and Chemistry and State Key Laboratory in Marine Pollution, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong, China;2. National Museum of Marine Biology and Aquarium, Pingtung 944, Taiwan, ROC;3. Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China |
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| Abstract: | The prognostic importance of electrophysiologic studies in patients with sustained ventricular tachyarrhythmias treated with amiodarone was prospectively studied in 100 consecutive patients. Sustained ventricular tachycardia (VT)/ventricular fibrillation (VF) was inducible in all patients before amiodarone therapy. After amiodarone administration 2 groups of patients were identified. In group 1 patients the ventricular tachyarrhythmia was no longer inducible and in group 2 patients the arrhythmia remained inducible. In group 1, no recurrent arrhythmia occurred during a follow-up of 18 +/- 10 months. In group 2, 38 of 80 patients (48%) had arrhythmia recurrence during a follow-up of 12 +/- 9 months. The difference between group 1 and 2 could not be explained by clinical variables, amiodarone doses or plasma concentrations, or electrocardiographic variables. In patients in whom cardiovascular collapse or other severe symptoms where noted during electrophysiologic study after amiodarone treatment, recurrences caused sudden death (n = 12). However, in patients in whom the induced arrhythmia produced moderate symptoms, the recurrent arrhythmia was nonfatal VT (n = 26). Electrophysiologic testing provides clinical guidance and predicts prognosis in patients treated with amiodarone as it does for the evaluation of other antiarrhythmic agents. |
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