Recurrent sustained ventricular tachycardia 3. Role of the electrophysiologic study in selection of antiarrhythmic regimens.

摘要: Twenty patients with recurrent sustained ventricular tachycardia (VT) underwent serial electrophysiological studies (EPS) 1) to determine the predictive value of EPS in selection antiarrhythmic therapy, and 2) establish therapeutic efficacy available agents. In each patient VT could be reproducibly initiated by programmed stimulation. After control EPS, effects several drugs (lidocaine, procainamide, quinidine, disopyramide diphenylhydantoin) on ability initiate were assessed. An oral regimen was chosen basis acute its effectiveness evaluated repeat 24--72 hours. Blood levels achieved acutely used as guidelines chronic therapy. 14 initiation prevented administration one or more 13 these patients, a based results recurrence three- 27-month follow-up. remaining patient, therapy not achieve blood procainamide shown effective intravenously, recurred. six no single drug combination during recurred all while agent make most difficult. Procainamide nine patients; quinidine three lidocaine diphenylhydantoin two patient. The mean duration 4.5 days. This study suggests that provides rapid identification successful can predict which conventional would ineffective, thereby identifying requiring aggressive modes