, Volume 29, Supplement 4, pp 33–44 | Cite as

Aggravation of Ventricular Arrhythmia

A Drug-induced Complication
  • Philip J. Podrid
Section 2: The ‘Risks’ Involved with the Clinical Use of Antiarrhythmic Agents


Each antiarrhythmic agent can cause side effects, but most of these are easily recognised by the patient or physician. However, one potentially serious side effect common to all of these drugs is aggravation of ventricular arrhythmia. Often this is without symptoms and goes unrecognised by the patient. It occurs in 11 to 16% of drug tests depending upon the method of drug evaluation employed. There are no ECG changes which predict its occurrence and blood concentrations of drug are usually within a therapeutic range. There are no clinical patient features which are associated with this toxic reaction and it does not correlate with the presence or extent of underlying heart disease, the nature of the presenting arrhythmia or the known electrophysiological properties of the antiarrhythmic drug. Careful evaluation of these drugs is therefore essential.


Ventricular Tachycardia Ventricular Arrhythmia Ventricular Fibrillation Quinidine Disopyramide 
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Tous les medicaments antiarythmiques peuvent être source d’effets indésirables, mais la plupart de ceux-ci sont aisément reconnaissables par le malade ou par le médecin. L’aggravation de l’arythmie ventriculaire leur est un commun risque, souvent asymptomatique, et qui se développe â l’insu du malade. On l’observe dans 11 à 16% des évaluations des effets des médicaments, suivant les techniques utilisées. Il n’existe pas de modification prémonitoire de l’ECG et les concentrations sanguines du médicament sont habituellement dans les normes thérapeutiques définies. On ne retrouve pas de pathologie associée, ni de corrélation avec la présence ou l’aggravation de la maladie cardiaque, le type d’arythmie ou ce qu’on sait des propriétés électrophysiologiques de Vantiarythmique. Une évaluation soigneuse de ces médicaments est en conséquence d’intérêt capital.


Jedes Antiarrhythmikum kann Nebenwirkungen verursachen, aber die meisten von ihnen werden vom Patienten oder Arzt leicht erkannt. Eine allen diesen Substanzen gemeinsame potentiell ernste Nebenwirkung ist jedoch die Verstärkung der ventrikuläre Arrhythmie. Oft erfolgt dies ohne Symptome und wird vom Patienten nicht erkannt. In Abhängigkeit der angewandten Erfassungsmelhode tritt sie bei11bis 16% der Pharmakaprüfungen auf. Es gibt keine EKG-Veränderungen, die das Auftreten vorhersagen, und die Blukonzentrationen der An:tiarrhythmika befinden sich meist im therapeutischen Bereich. Es existieren keine mit der toxischen Reaktion assoziierte Patientenmerkmale noch Korrelationen mit dem Vorhandensein oder Ausmaβ von zugrundeliegenden Herzkrankheiten, der Art der vorliegenden Arrhythmie oder den bekannten elektrophysiologischen Eigenschaften des Antiarrhythmikums. Eine sorgfältige Beurteilung dieser Pharmaka ist daher notwendig.


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Copyright information

© ADIS Press Limited 1985

Authors and Affiliations

  • Philip J. Podrid
    • 1
  1. 1.Cardiovascular Laboratories, Department of NutritionHarvard School of Public HealthBostonUSA

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