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Ventrikuläre Arrhythmien im Alter — therapeutische Überlegungen

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Therapie im Alter

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Zusammenfassung

Fortschritte in der Elektrophysiologie, Pharmakologie, in der Langzeit-EKG- und Schrittmachertechnologie sowie in der Herzchirurgie haben die diagnostischen und therapeutischen Möglichkeiten einer wirkungsvolleren Behandlung lebensbedrohlicher ventrikulärer Arrhythmien bei Patienten aller Altersstufen erheblich erweitert. Der wichtigste begrenzende Faktor für die Anwendung dieser Fortschritte auch bei alten Patienten ist nicht das Alter selbst. Vielmehr werden die von neuen Medikamenten und Techniken erwarteten Vorteile gemindert durch die größere Zahl von Begleiterkrankungen und die altersabhängigen Unterschiede in Absorption, Metabolismus, Exkretion und Toxizität von Antiarrhythmika, die für den alten Menschen ein größeres Risiko bedeuten und ihn anfälliger für schwere Nebenwirkungen machen (Harris, 1982).

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Literatur

  • Anderson KP, Mason JW (1982) Surgical management of ventricular tachyarrhythmias. Clin Cardiol 6: 415–425

    Article  Google Scholar 

  • Baltazar R, Mower MM, Salomon J, Labib A (1981) Exertional ventricular tachycardia. Am Heart J 101: 354–355

    Article  PubMed  CAS  Google Scholar 

  • Bauernfeind RA, Hoff JV, Swiryn S, Palileo E, Strasberg B, Scagliotti D, Rosen KM (1983) Electrophysiologic testing of bretylium tosylate in sustained ventricular tachycardia. Am Heart J 105: 973–979

    Article  PubMed  CAS  Google Scholar 

  • Bernstein JG, Koch-Weser J (1972) Effectiveness of bretylium tosylate against refractory ventricular arrhythmias. Circulation 45: 1024–1034

    PubMed  CAS  Google Scholar 

  • Bigge, JT, Weld FM, Rolnitzky LM (1981) Prevalence, characteristics and significance of ventricular tachycardia (three or more complexes) detected with ambulatory electrocardiog-raphic recording in the late hospital phase of acute myocardial infarction. Am J Cardiol 48: 815

    Article  Google Scholar 

  • Bigger JT (1983) Ventricular tachycardia in acute, subacute, and chronic ischemic heart disease. Primary Cardiology May: 55–66

    Google Scholar 

  • Califf RM, McKinnis RA, McNeer JF, Harrell FE, Lee KL, Pryor DB, Waugh RA, Harris PJ, Rosati RA, Wagner GS (1983) Prognostic value of ventricular arrhythmias associated with treadmill exercise testing in patients studied with cardiac catheterization for suspected ischemic heart disease. JACC 2

    Google Scholar 

  • Califf RM, McKinnis RA, Burks J, Lee KL. Harrell FE, Behar VS, Pryor DB, Wagner GS, Rosati RA (1982) Prognostic implications of ventricular arrhythmias during 24 hour ambulatory monitoring in patients undergoing cardiac catheterization for coronary artery disease. Am J Cardiol 50: 23–31

    Article  PubMed  CAS  Google Scholar 

  • Camm AJ, Evans KE, Ward DE, Martin A (1980) The rhythm of the heart in active elderly subjects. Am Heart J 99: 598

    Article  PubMed  CAS  Google Scholar 

  • Clarke JM, Hammert J, Shelton JR et al (1977) The rhythm of the normal human heart. Lancet 2: 508

    Google Scholar 

  • Cooper MW (1983) PVCs in the elderly: When should they be treated? Geriatrics 38: 69–77

    PubMed  CAS  Google Scholar 

  • de Soyza N, Haisten J, Murphy ML, Bissett JK, Doherty JE, Thompson CH (1982) Correlation of left ventricular wall motion abnormalities with ventricular arrhythmias in patients with coronary artery disease. Int J Cardiol 1: 281–288

    Article  PubMed  Google Scholar 

  • Dobmeyer DJ, Stine RA, Leier CU, Greenberg R, Schaal SF (1983) The arrythmogenic effects of caffeine in human beings. N Engl J Med 308: 814–816

    Article  PubMed  CAS  Google Scholar 

  • Eastway RJ, Maloney JD, Yiannikas J, et al.: (1982) Electrophysiologically guided surgical treatment of recurrent substained ventricular tachycardia: Variables influencing the decision to intervene. Cleve Clin Q 49: 107–117

    Google Scholar 

  • Gardner MJ, Waxman HL, Buxton AE, Cain ME, Josephson ME (1982) Termination of ventricular tachycardia: Evaluation of a new pacing method. Am J Cardiol 50: 1338–1345

    Article  PubMed  CAS  Google Scholar 

  • Giardina E-GV, Bigger JT Jr, Glassman AH, Perel JM, Kantor SJ (1979) The electrocardio-graphic and antiarrhythmic effects of imipramine hydrochloride at therapeutic plasma concentrations. Circulation 60: 1045–1052

    PubMed  CAS  Google Scholar 

  • Glasser SP, Clarke PJ, Applebaum HJ (1979) Occurence of frequent complex arrhythmias detected by ambulatory monitoring. Findings in an apparently healthy asymptomatic elderly population. Chest 75: 565

    Article  PubMed  CAS  Google Scholar 

  • Greene HL, Graham EL, Werner JA, Sears GK, Gross BW, Gorham JP, Kudenchuk PJ, Trobaugh GB (1983) Toxic and therapeutic effects of amiodarone in the treatment of cardiac arrhythmias. JACC 2

    Google Scholar 

  • Hamer AW, Finerman WB, Peter T, Mandel WJ (1981) Disparity between the clinical and electrophysiologic effects of amiodarone in the treatment of recurrent ventricular tachyarrhyth-mias. Am Heart J 102: 992–1000

    Article  PubMed  CAS  Google Scholar 

  • Han J (1971) The concepts of reentrant activity responsible for ectopic rhythms. Am J Cardiol 28: 253–262

    Article  PubMed  CAS  Google Scholar 

  • Han J, Goel BG (1972) Electrophysiologic precursors of ventricular tachyarrhythmias. Arch Intern Med, 129: 749–755

    Article  PubMed  CAS  Google Scholar 

  • Harken AH, Horowitz LN, Josephson ME (1980) Comparison of standard aneurysmectomy and aneurysmectomy with directed endocardial reseoction for the treatment of recurrent sustained ventricular tachycardia. J Thorac Cardiovasc Surg 80: 527–534

    PubMed  CAS  Google Scholar 

  • Harris R (Oct. 21, 1982) Cardiac arrhythmias in the aged. Ist International Erlangen-Nuremberg Symposium on Experimental Gerontology, Nuremberg, West Germany (in press)

    Google Scholar 

  • Hartzler GO (1983) Electrode catheter ablation of refractory focal ventricular tachycardia. JACC 2

    Google Scholar 

  • Heger JJ, Prystowsky EN, Jackman WM, Naccarelli GV, Warfel KA, Rinkenberger RL, Zipes DP (1981) Amiodarone: Clinical efficacy and electrophysiology during long-term therapy for recurrent ventricular tachycardia or ventricular fibrillation. New Eng J Med 305: 539–545

    Article  PubMed  CAS  Google Scholar 

  • Heger JJ, Prystowsky EN, Zipes DP (1982) New antiarrhythmics: Amiodarone and encainide. Drug Therapy September: 153–161

    Google Scholar 

  • Horowitz LN, Harken AH, Kastor JA, Josephson ME (1980) Ventricular resection guided by epicardial and endocardial mapping for treatment of recurrent ventricular tachycardia. New Eng J Med 302: 589–593

    Article  PubMed  CAS  Google Scholar 

  • Johnson RA, Wasserman AG, Leiboff RH, Katz RJ, Bren GB, Varghese J, Ross AM (1983) JACC 2

    Google Scholar 

  • Josephson ME, Harken AH, Horowitz LN (1979) Endocardial excision: A new surgical technique for the treatment of recurrent ventricular tachycardia. Circulation 60: 1430–1439

    PubMed  CAS  Google Scholar 

  • Julian DG, Goldstein S (1983) New strategies for MI, sudden death, and angina. Modern Medicine p. 27

    Google Scholar 

  • Kay GN, Plumb VJ, Arciniegas JG, Henthorn RW, Waldo AL (1983) Torsade de pointes: The long-short initiating sequence and other clinical features: Observations in 32 patients. JACC 2

    Google Scholar 

  • Khan AH, Carleton RA, Chown M (1983) Aprindine therapy for refractory ventricular tachycardia. Arch Intern Med 143: 229–232

    Article  PubMed  CAS  Google Scholar 

  • Kienzle MG, Doherty JU, Roy D, Waxman HL, Harken AH, Josephson ME (1983) Subendocar-dial resection for refractory ventricular tachycardia: Effects on ambulatory electrocardiogram, programmed stimulation and ejection fraction, and relation to outcome. JACC 2

    Google Scholar 

  • Lewis EG, Antman EM, Graboys TB (1983) Detailed analysis of 24 hour ambulatory electrocar-diographic recordings during ventricular fibrillation or torsade de pointes. JACC 2: 426–436

    PubMed  CAS  Google Scholar 

  • Lown B, Wolf M: Approaches to sudden death from coronary heart disease Circulation 44: 130–142, 1972

    Google Scholar 

  • Mandel W (1981) Disparity between the clinical and electrophysiologic effects of amiodarone in the treatment of recurrent ventricular tachyarrhythmias. Am Heart J 102: 992–1000

    Article  PubMed  Google Scholar 

  • Martin A (1983) Evaluation of dysrhythmias in apparently healthy older subjects. Geriatric Med Today 2: 56–62

    Google Scholar 

  • Mihalick MJ, Fisch C (1974) Eiectrocardiographic findings in the aged. Am Heart J 87: 117

    Article  PubMed  CAS  Google Scholar 

  • Mirowski M (1983) Management of malignant ventricular tachyarrhythmias with automatic implanted cardioverter-defibrillators. Mod Concepts Cardiovasc Dis 52:8: 41–44

    Google Scholar 

  • Mirowski M, Reid PR, Winkle RA, Mower MM, Watkins L, Stinson EB, Griffith LSC, Kallman CH, Weisfeldt ML (1983) Mortality in patients with implanted automatic defibrillators. Ann Intern Med 98: 585–587

    PubMed  CAS  Google Scholar 

  • Morady F, Shen E, Schwartz A, Hess D. Bhandari A. Sung RJ, Scheinmann MM (1983) Long-term follow-up of patients with recurrent unexplained syncope evaluated by electrophysiologic testing. JACC 2

    Google Scholar 

  • Moss AJ (1980) Clinical significance of ventricular arrhythmias in patients with and without coronary artery disease. Prog Cardiovas Dis 23: 33–52

    Article  CAS  Google Scholar 

  • Panidis I, Morganroth J (1983) Sudden death in hospitalized patients: Cardiac rhythm disturbances detected by ambulatory eiectrocardiographic monitoring. JACC 2

    Google Scholar 

  • Podrid PJ, Schoeneberger A, Lown B, Lampert S, Matos J, Porterfield J, Raeder E, Corrigan E (1983) Use of non-sustained ventricular tachycardia as a guide to antiarrhythmic drug therapy in patients with malignant ventricular arrhythmia. Am Heart J 105: 181–188

    Article  PubMed  CAS  Google Scholar 

  • Pratt CM, Francis MJ, Luck JC, Wyndham CR, Miller RR, Quinones MA (1983) Analysis of ambulatory electrocardiograms in 15 patients during spontaneous ventricular fibrillation with special reference to preceding arrhythmic events. JACC 2

    Google Scholar 

  • Raftery EB, Cashman PBB (1976) Long-term recordings of the electrocardiogram in a normal population. Postgrad Med J 52 (Suppl.) 32

    Article  PubMed  Google Scholar 

  • Rodstein M, Oei LS (1979) Cardiovascular side effects of long-term therapy with tricyclic antidepressants in the aged. J Am Geriat Soc 27: 231–234

    PubMed  CAS  Google Scholar 

  • Schamroth L (1964) Ventriculai extrasystoles, ventricular tachycardia, and ventricular fibrillation: Clinical-electrocardiographic considerations. Prog Cardiovas Dis 30: 17–26

    Google Scholar 

  • Selzer A, Wray HW (1964) Quinidine syncope: Paroxysmal ventricular fibrillation occurring during treatment of chronic atrial arrhythmias. Circulation 30: 17–26

    PubMed  CAS  Google Scholar 

  • Svanborg A (1977) Seventy-year-old people in Gottenberg. A population study in an industrialized Swedish City. II General presentation of social and medical conditions. Acta Med Scand (Suppl.) 611

    Google Scholar 

  • Talbot RG, Nimmo J, Julian DG, Clark RA, Neilson JMM. Prescott IF (1973) Treatment of ventricular arrhythmias with mexiletine (KÖ1173) Lancet 2: 399–403

    Article  PubMed  CAS  Google Scholar 

  • Tommaso CL, Kehoe RF (1983) Sudden cardiac death: risk, evaluation, and primary prevention. Geriatrics 38: 42–53

    PubMed  CAS  Google Scholar 

  • Vera L, Mason, DT (1981) Reentry versus automaticity: Role in tachyarrhythmia genesis and antiarrhythmic therapy. Am Heart J 101: 329–338

    Article  PubMed  CAS  Google Scholar 

  • Waxman HL, Groh WC, Marchlinski RE, Buxton AE, Sadowski LM, Horowitz LN, Josephson ME, Kastor JA (1982) Amiodarone for control of sustained ventricular tachyarrhythmia: Clinical and electrophysiologic effects in 51 patients. Am J Cardiol 50: 1066–1074

    Article  PubMed  CAS  Google Scholar 

  • Zipes DP, Jackman WM, Heger JJ, Chilson DA, Browne KF, Naccarelli GV, Rahilly GT Jr, Prystowsky EN (1982) Clinical transvenous cardioversion of recurrent life-threatening ventricular tachyarrhythmias: Low energy synchronized cardioversion of ventricular tachycardia and termination of ventricular fibrillation in patients using a catheter electrode. Am Heart J 103: 789–794

    Article  PubMed  CAS  Google Scholar 

  • Zipes DP, Troup PJ (1978) New antiarrhythmic agents: Amiodarone, aprindine, disopyramide, ethmozin, mexiletine, tocainide, verapamil. Am J Cardiol 41: 1005–1024

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Center for the Study of Aging, 706 Madison Avenue, Albany, New York, 12208, USA

    Dr. R. Harris

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  1. Dr. R. Harris
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Editors and Affiliations

  1. Rheinische Landesklinik Köln, Wilhelm-Griesinger-Str. 23, 5000, Köln 91, Deutschland

    M. Bergener

  2. Städtisches Krankenhaus Klinik Innere Medizin, Gotenstraße 6-8, 6230, Frankfurt/Höchst, Deutschland

    B. Kark

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© 1984 Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt

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Harris, R. (1984). Ventrikuläre Arrhythmien im Alter — therapeutische Überlegungen. In: Bergener, M., Kark, B. (eds) Therapie im Alter. Steinkopff. https://doi.org/10.1007/978-3-642-85339-5_14

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  • DOI: https://doi.org/10.1007/978-3-642-85339-5_14

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-7985-0642-8

  • Online ISBN: 978-3-642-85339-5

  • eBook Packages: Springer Book Archive

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