Circulation, Vol 58, 971-985, Copyright © 1978 by American Heart Association
JW Mason and RA Winkle
We performed intracardiac electrophysiologic studies in 33 patients with
recurrent ventricular tachycardia. Nineteen patients underwent one, 10
patients two, and four patients three serial electrophysiologic studies.
Ventricular tachycardia was successfully induced in 83% of the patients,
and pacing methods were successful in terminating tachycardia in 71% of the
studies, although pacing-induced acceleration of ventricular tachycardia
occurred at least once in 36% of the studies. Seventeen of the 33 patients
(52%) required a total of 24 external direct current cardioversions during
study. In 21 patients a variety of antiarrhythmic drugs were given I.V. and
attempts at ventricular tachycardia induction were repeated to assess
prophylactic effects of the drugs. An acutely effective drug or combination
of drugs was found in 15 of the patients (71%). Fourteen of the 15 were
placed on chronic oral therapy with the effective agent and were followed
for an average period of 8.1 months (range one to 33 months). In all 14
patients we could document complete (13 patients) or partial (one patient)
long- term prophylaxis against ventricular tachycardia. We conclude that
drug efficacy trials in patients with recurrent ventricular tachycardia
using intracardiac pacing techniques is a rapid and accurate method of
selecting effective long-term antiarrhythmic therapy.
ARTICLES
Electrode-catheter arrhythmia induction in the selection and assessment of antiarrhythmic drug therapy for recurrent ventricular tachycardia
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