Abstract
Many studies have shown the malignant potential of symptomatic sustained ventricular arrhythmias, i.e., ventricular tachycardia (VT) or ventricular fibrillation (VF). Routine clinical evaluation usually reveals ample evidence for the existence of heart disease in patients with these arrhythmias. Coronary heart disease is by far the most frequently occurring etiologic form of heart disease (about 80%) followed by cardiomyopathy and valvular heart disease. Often ventricular scarring and/or hypertrophy is present in patients with sustained VA. Left ventricular dysfunction is apparent clinically as heart failure or detectable by radionuclide ventriculography. A 24-hour ECG recording frequently will reveal repetitive ventricular arrhythmias, including runs of unsustained VT. When antiarrhythmic drug treatment is stopped, electrophysiologic studies are capable of inducing sustained VT or VF in about 80% of those who present with recurrent sustained VT as the clinical arrhythmia and in about 70% of those who had a cardiac arrest and were found in VF (1–4).
This is a preview of subscription content, log in via an institution to check access.
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
Josephson ME, Horowitz LN: Electrophysiologic approach to therapy of recurrent sustained ventricular tachycardia. Am J Cardiol. 43:631–642, 1979.
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. 303:1073–1077, 1980.
Horowitz LN, Josephson ME, Kastor JA: Intracardiac electrophysiologic studies as a method for the optimization of drug therapy in chronic ventricular arrhythmia. Prog Cardiovasc Dis 23:81–98, 1980.
Ruskin JN, DiMarco JP, Garan H: Out-of-hospital cardiac arrest. Electrophysiologic observations and selection of long-term antiarrhythmic therapy. N Engl J Med 303:607–613, 1980.
Graboys TB, Lown B, Podrid PJ, DeSilva R: Long-term survival of patients with ventricular arrhythmia treated with antiarrhythmic drugs. Am J Cardiol 50:437–443, 1982.
Vlay SC, Kallman LH, Reid PR: Prognostic assessment of survivors of ventricular tachycaridia and ventricular fibrillation with ambulatory monitoring. Am J Cardiol 54:87–90, 1984.
Hoffman A, Schutz E, White R, Follath F, Burckhardt D: Suppression of high-grade ventricular ectopic activity by antiarrhythmic drug treatment as a marker for survival in patients with chronic coronary artery disease. Am Heart J 107:1103–1108, 1984.
Swerdlow CD, Winkle RA, Mason JW: Determinants of survival in patients with ventricular tachyarrhythmias. N Engl J Med 308:1436–42, 1983.
Heger JJ, Prystowsky EN, Zipes DP: Clinical efficacy of amiodarone in treatment of recurrent ventricular tachycardia and ventricular fibrillation. Am Heart J 106: 887–894, 1983.
Waxman HL: The efficacy of amiodarone for ventricular arrhythmias cannot be predicted with clinical electrophysiological studies. Internat J Cardiol 3: 76–80, 1983.
Peter T, Hamer A, Mandel WJ, Weiss D: Evaluation of amiodarone therapy in the treatment of drug-resistant cardiac arrhythmias: long-term follow-up. Am Heart J 106: 943–950, 1983.
McGovern B, Ruskin JN: The efficacy of amiodarone for ventricular arrhythmias can be predicted with clinical electrophysiological studies. Intern J Cardiol 3: 71–76, 1983.
Borggrefe M, Breithardt G, Seipel L: Value of serial electrophysiological testing in the treatment of ventricular tachyarrhythmias with amiodarone (Abstr). Circulation 68: III-381, 1983.
Horowitz LN, Greenspan AM, Spielman SR, Webb CR, Morganroth J, Rotmensch H, Sokoloff NM, Rae AP, Segal BL, Kay HR: Usefulness of electrophysiologic testing in evaluation of amiodarone therapy for sustained ventricular tachyarrhythmias associated with coronary heart disease. Am J Cardiol, In press, February 1985.
Livelli FD, Bigger JT Jr, Reiffei JA, Gang ES, Patton JN, Noethling PM, Rolnitzky LM, Gliklich JI: Response to programmed ventricular stimulation: sensitivity, specificity and relationship to heart disease. Am J Cardiol 50: 452–458, 1982
Oliver GC, Ripley KL, Miller JP, Thomas LJ Jr: A critical review of computer arrhythmia detection. In: L Pordy (ed) Computer electrocardiography: current status and criteria. Futura Press, Mount Kisco, NY, 1977, pp 319–325.
Hermes RE, GC Oliver: Use of the American Heart Association database. In: NK Wenger, MB Mock, I Ringqvist (eds) Ambulatory electrocardiographic recording. Year Book Medical Publishers, Inc, Chicago, 1981, pp 165–181.
Clark KW, Rolnitzky LM, Miller JP, DeCamilla JJ, Kleiger RE, Thanavaro S, Bigger JT Jr and other MPIP participants: Ambulatory ECG analysis shared by two independent computer labs in the multicenter post-infarction program (MPIP). In: Computers in cardiology 1980, IEEE Computer Society, Long Beach, CA, 1981, pp 271–275.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1985 Martinus Nijhoff Publishing, Boston
About this chapter
Cite this chapter
Bigger, J.T. (1985). Holter/Exercise and Electrophysiologic Methods for Evaluating Drug Therapy for Malignant Ventricular Arrhythmias: Do We Need Both Models?. In: Morganroth, J., Moore, E.N. (eds) Cardiac Arrhythmias: New Therapeutic Drugs and Devices. Developments in Cardiovascular Medicine, vol 47. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2595-6_14
Download citation
DOI: https://doi.org/10.1007/978-1-4613-2595-6_14
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4612-9626-3
Online ISBN: 978-1-4613-2595-6
eBook Packages: Springer Book Archive