Prevention of recurrent sudden cardiac arrest: role of provocative electropharmacologic testing. J Am Coll Cardiol 1983 Sep;2(3):418-25
Date
09/01/1983Pubmed ID
6875106DOI
10.1016/s0735-1097(83)80267-8Abstract
This study evaluates the usefulness of serial provocative electropharmacologic testing for predicting the efficacy of prophylactic antiarrhythmic treatment regimens in patients resuscitated from sudden cardiac arrest in the absence of acute myocardial infarction. Testing was carried out in 34 consecutive patients (28 men and 6 women) who required cardiopulmonary resuscitation and direct current countershock for treatment of primary ventricular fibrillation (28 patients), ventricular tachycardia (5 patients) or excessively rapid heart rate during atrial fibrillation with preexcitation (1 patient). In 8 (24%) of the 34 patients, drug testing either was not feasible because of absence of inducible arrhythmia or was incomplete because of patient withdrawal from study; and 3 of these 8 patients had recurrent sudden cardiac arrest within 10 to 19 months. In an additional five patients, treatment regimens failed to prevent initiation of sustained ventricular tachyarrhythmias in the catheterization laboratory, and two of these five patients had cardiac arrest recurrences within 2 weeks to 25 months of follow-up. In the remaining 21 (62%) of the 34 patients, including 3 patients with preexcitation syndrome, a drug regimen or surgical treatment, or both, was found that prevented inducible life-threatening tachyarrhythmias in the laboratory. Subsequently, only 1 (5%) of these 21 patients died suddenly within a 7 to 38 month (mean +/- standard deviation, 18 +/- 8.3) follow-up period. Thus, provocative electropharmacologic testing appears to be useful in predicting response to therapy in survivors of sudden cardiac arrest.
Author List
Benditt DG, Benson DW Jr, Klein GJ, Pritzker MR, Kriett JM, Anderson RWMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Anti-Arrhythmia Agents
Arrhythmias, Cardiac
Cardiac Pacing, Artificial
Electric Countershock
Female
Follow-Up Studies
Heart Arrest
Humans
Male
Middle Aged
Recurrence
Resuscitation
Risk
Tachycardia
Ventricular Fibrillation
Wolff-Parkinson-White Syndrome
