Abstract
The mortality of patients with severe left ventricular dysfunction and congestive heart failure ranges from 25 to 50%. Almost half of the deaths of patients with heart failure are sudden, presumably due to malignant ventricular arrhythmias (1–5). Moreover, in such patients asymptomatic or only minimally symptomatic ventricular arrhythmias are common (1–5). Frequent and complex ventricular arrhythmias which occur in conjunction with depressed left ventricular function are associated with an increased risk of malignant ventricular tachyarrhythmias and it would seem logical that suppression of these asymptomatic arrhythmias would improve the prognosis of patients with heart failure. This, however, has yet to be validated. In fact, little data have been presented to support the notion that suppression of ventricular arrhythmias will lead to a reduction in the sudden death rate in these patients.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Franciosa JA, Wilen M, Ziesche, et al: Survival in men with severe chronic left ventricular failure due to either coronary heart disease or idiopathic dilated cardiomyopathy. Am J Cardiol 1983;51:831–836.
Wilson JR, Schwartz JS, Sutton M, et al: Prognosis in severe heart failure: Relation to hemodynamic measurements and ventricular ectopic activity. J Am Coll Cardiol 1983;2:403–410.
Unverferth DV, Magorien RD, Moeschberger ML, et Factors influencing the one-year mortality of dilated cardiomyopathy. Am J Cariol 1984;54:147–152.
Fuster V. Gersh BJ, Giuliani ER, et al: The natural history of idiopathic dilated cardiomyopathy. Am J Cardiol 1981;47:525–531.
Califf RM, Burks JM, Behar VS, et al: Relationship among ventricular arrhythmias, coronary artery disease and angiographic and electrocardiographic indicators of myocardial fibrosis. Circulation 1978;57:725–732.
Morganroth J, Anderson JL, Gentzkow GD: Classification by type of ventricular arrhythmia predicts frequency of adverse cardiac events from flecainide. J Am Coll Cardiol 1986;8:607–615
Morganroth J: Risk factors for the development of proarrhythmic events. Am J Cardiol (in press).
Rae AP, Greenspan AM, Spielman SR, Horowitz LN: Proarrhythmia during electorphysiologic studies. (abstr) Brit Heart J (in press).
Schwartz SP, Hallinger L, Imperialli A: Transient ventricular fibrillation. IV. The effects of procainanide on patients with transient ventricular fibrillation during established auriculo-ventricular dissociation. Circulation 1952;6:193–200.
Selzer A, Wray HW: Quinidine syncope: Paroxysmal ventricular fibrillation occurring during treating of atrial arrhythmia. Circulation 1964;30:17–26.
Cocco G, Strozzi C, Chu D, Pansini R: Torsade de pointes as a manifestation of mexiletine toxicity. Am Heart J 1980;100:878–880.
Strasberg B. Sclarovsky S, Erdberg A, Duffy CE, Lam W, Swiryn S, Agmon J, Rosen KM: Procainamide-induced polymorphous ventricular tachycardia. Am J Cardiol 1981;47:1309–1314.
Winkle RA, Mason JW, Griffin JC, Ross D: Malignant ventricular tachycardia associated with the use of encainide. Am Heart J 1981;102:857–864.
Velebit V, Podrid P, Lown B, Cohen BH, Graboys TB: Aggravation and provocation of ventricular arrhythmias by antiarrhythmic drugs. Circulation 1982;65:886–894.
Sclarovsky S, Lewin RF, Kracoff O, Strasberg B, Arditta A, Agmon J: Amiodarone-induced polymorphous ventricular tachycardia. Am Heart J 1983;105:6–12.
Mason JW, Winkle RA: Electrode-catheter arrhythmia induction in the selection and assessment of antiarrhythmic drug therapy for recurrent ventricular tachycardia. Circulation 1978;58:971–985.
Horowitz LN, Josephson ME, Farshidi A, Spielman SR, Michelson EL, Greenspan AM: Recurrent sustained ventricular tachycardia 3. Role of the elctrophysiologic study in the selection of antiarrhythmic regimens. Circulation 1978;58:986–997.
Swerdlow CD, Winkle RA, Mason JW: Determinants of survival in patients with ventricular tachyarrhythmia. N Engl J Med 1983;308:1436–1442.
Mason JW, Winkle RA: Accuracy of the ventricular tachycardia-induction study for predicting long-term efficacy and inefficacy of antiarrhythmic drugs. N Engl J Med 1980;303:1073–1077.
Ruskin JH, McGovern B, Garan H, DiMarco JP, Kelly E: Antiarrhythmic drugs: A possible cause of out-of-hospital cardiac arrest. N Engl J Med 1983;309:1302–1306.
Rinkenberger RL, Prystowsky EN, Jackman WM, Naccarelli GV, Heger JJ, Zipes DP: Drug conversion of nonsustained ventricular tachycardia to sustained ventricular tachycardia during serial electrophysiologic studies: Identification of drugs that exacerbate tachycardia and potential mechanisms. Am Heart J 1982;103:177–184.
Torres V, Flowers D, Somberg JC: The arrhythmogenicity of antiarrhythmic agents. Am Heart J 1985;109:1090–1097.
Rae AP, Greenspan AM, Spielman SR, Sokoloff NM, Webb CR, Kay HR, Horowitz LN: Antiarrhythmic drug efficacy for ventricular tachyarrhythmias associated with coronary artery disease as assessed by electrophysiologic studies. Am J Cardiol 1985;55:1494–1499.
Poser RF, Podrid PJ, Lombardi F, Lown B: Aggravation of arrhythmia induced with antiarrhythmic drugs during electrophysiologic testing. Am Heart J 1985;110:9–16.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1987 Martinus Nijhoff Publishing, Boston
About this chapter
Cite this chapter
Horowitz, L.N. (1987). Criteria for Proarrhythmia in Patients with Congestive Heart Failure: Use of Electrophysiologic Testing. In: Morganroth, J., Moore, E.N. (eds) Congestive Heart Failure. Developments in Cardiovascular Medicine, vol 75. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2077-7_9
Download citation
DOI: https://doi.org/10.1007/978-1-4613-2077-7_9
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4612-9232-6
Online ISBN: 978-1-4613-2077-7
eBook Packages: Springer Book Archive