Is programmed stimulation of value in predicting the long-term success of antiarrhythmic therapy for ventricular tachycardias?

Soo G. Kim, S. W. Seiden, S. D. Felder, L. E. Waspe, John Devens Fisher

Research output: Contribution to journalArticle

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Abstract

We studied the value of programmed stimulation in assessing the efficacy of antiarrhythmic agents in 52 patients with sustained ventricular tachycardia. All patients in this nonrandomized study had ventricular tachycardia inducible by programmed stimulation and also had frequent ventricular premature complexes (≥30 per hour) on Holter-monitor recordings before therapy. The efficacy of antiarrhythmic agents was assessed by both programmed stimulation and Holter recordings during serial drug testing. A regimen was deemed effective according to the programmed-stimulation criteria in 25 patients (Group 1). Twenty-seven patients in whom tachycardia could still be induced during programmed stimulation despite extensive drug trials were discharged on a regimen that caused a marked reduction of ventricular premature complexes according to Holter monitoring (Group 2). In 23 patients no effective drug regimen was identified by either set of efficacy criteria, and these patients were excluded from the present analysis. Follow-up lasted 18.6 ± 13.9 months. Rates of arrhythmia-free survival at 12 and 24 months were 88 percent and 72 percent, respectively, in Group 1 and 84 per cent and 75 percent in Group 2 (P = 0.637). We conclude that demonstration of antiarrhythmic efficacy by programmed stimulation predicts a good clinical outcome, that inefficacy as shown by the programmed-stimulation protocol used in this study may not preclude a good outcome if there is a marked reduction of spontaneous ventricular premature complexes on Holter monitoring, and that randomized trials should be conducted to validate the results of this observational study.

Original languageEnglish (US)
Pages (from-to)356-362
Number of pages7
JournalNew England Journal of Medicine
Volume315
Issue number6
StatePublished - 1986

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Ventricular Tachycardia
Ventricular Premature Complexes
Ambulatory Electrocardiography
Therapeutics
Pharmaceutical Preparations
Tachycardia
Observational Studies
Cardiac Arrhythmias
Survival

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Is programmed stimulation of value in predicting the long-term success of antiarrhythmic therapy for ventricular tachycardias? / Kim, Soo G.; Seiden, S. W.; Felder, S. D.; Waspe, L. E.; Fisher, John Devens.

In: New England Journal of Medicine, Vol. 315, No. 6, 1986, p. 356-362.

Research output: Contribution to journalArticle

Kim, Soo G. ; Seiden, S. W. ; Felder, S. D. ; Waspe, L. E. ; Fisher, John Devens. / Is programmed stimulation of value in predicting the long-term success of antiarrhythmic therapy for ventricular tachycardias?. In: New England Journal of Medicine. 1986 ; Vol. 315, No. 6. pp. 356-362.
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