Usefulness of the electrophysiology laboratory for evaluation of proarrhythmic drug response in coronary artery disease.
Publication/Presentation Date
4-15-1991
Abstract
Two potential manifestations of proarrhythmic responses to type IA antiarrhythmic agents in the electrophysiology laboratory were evaluated in 122 patients with chronic coronary artery disease and previous myocardial infarction: (1) conversion of uniform nonsustained ventricular tachycardia (VT) into sustained VT after drug administration, and (2) induction of sustained VT by fewer extrastimuli after drug administration. Forty-two patients were evaluated for nonsustained VT. Eighty patients were evaluated for sustained VT: 30 of these had spontaneous sustained VT only while receiving empiric therapy with quinidine or procainamide, whereas the remaining 50 developed spontaneous VT in the absence of antiarrhythmic drugs. All patients underwent programmed stimulation in the baseline state and after procainamide. Four patients had conversion of induced uniform nonsustained VT into the same morphology, but sustained VT after procainamide administration. These responses only occurred in patients evaluated for nonsustained VT. Over 90% of patients presenting with sustained VT had uniform sustained VT induced at the baseline study and after procainamide, regardless of whether the spontaneous arrhythmia occurred only in the presence or absence of antiarrhythmic drugs. There was no significant difference in the change in mode of induction from baseline to procainamide study, regardless of whether patients had developed spontaneous VT only in the presence or absence of antiarrhythmic drugs. One patient with no inducible VT at the baseline study had inducible uniform sustained VT after procainamide administration, and 1 patient with inducible VT at baseline developed spontaneous sustained uniform VT after procainamide administration. Both patients had developed spontaneous sustained VT only while receiving therapy with type IA agents.(ABSTRACT TRUNCATED AT 250 WORDS)
Volume
67
Issue
9
First Page
835
Last Page
842
ISSN
0002-9149
Published In/Presented At
Buxton, A. E., Rosenthal, M. E., Marchlinski, F. E., Miller, J. M., Flores, B., & Josephson, M. E. (1991). Usefulness of the electrophysiology laboratory for evaluation of proarrhythmic drug response in coronary artery disease. The American journal of cardiology, 67(9), 835–842. https://doi.org/10.1016/0002-9149(91)90616-s
Disciplines
Medicine and Health Sciences
PubMedID
1707220
Department(s)
Department of Medicine
Document Type
Article