Arrhythmogenic effects of antiarrhythmic drugs

A study of 506 patients treated for ventricular tachycardia or fibrillation

Marshall S. Stanton, Eric N. Prystowsky, Naomi S. Fineberg, William M. Miles, Douglas P. Zipes, James J. Heger

Research output: Contribution to journalArticle

113 Citations (Scopus)

Abstract

Antiarrhythmic therapy in 506 consecutive patients undergoing 1,268 antiarrhythmic drug trials for ventricular tachycardia or ventricular fibrillation was reviewed for evidence of arrhythmogenic drug effect defined as the occurrence of a new form of ventricular tachyarrhythmia temporally associated with initiation of drug therapy or dosage increase. Arrhythmogenic effects occurred in 6.9% of patients and 3.4% of drug trials. This ranged from a high of 11.8% caused by encainide to none occurring with procainamide, tocainide or beta-adrenergic blocking drugs. The incidence of arrhythmogenesis was significantly greater in patients whose presenting arrhythmia was sustained ventricular tachycardia than it was in those who presented with nonsustained ventricular tachycardia or ventricular fibrillation (p = 0.02). Decreased systolic function measured echocardiographically at the base of the left ventricle was associated with an increased incidence of arrhythmogenic effects (p = 0.006) whereas global left ventricular ejection fraction was not. Age, gender, cardiac diagnosis, location of prior myocardial infarction and New York Heart Association functional class for heart failure were not related to the occurrence of drug-induced arrhythmias. These findings emphasize the need for in-hospital cardiac monitoring during initiation of antiarrhythmic drug therapy for ventricular tachyarrhythmias.

Original languageEnglish
Pages (from-to)209-215
Number of pages7
JournalJournal of the American College of Cardiology
Volume14
Issue number1
DOIs
StatePublished - 1989

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Anti-Arrhythmia Agents
Ventricular Fibrillation
Ventricular Tachycardia
Tachycardia
Cardiac Arrhythmias
Encainide
Tocainide
Pharmaceutical Preparations
Procainamide
Drug Therapy
Incidence
Stroke Volume
Adrenergic Agents
Heart Ventricles
Heart Failure
Myocardial Infarction
Therapeutics

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Arrhythmogenic effects of antiarrhythmic drugs : A study of 506 patients treated for ventricular tachycardia or fibrillation. / Stanton, Marshall S.; Prystowsky, Eric N.; Fineberg, Naomi S.; Miles, William M.; Zipes, Douglas P.; Heger, James J.

In: Journal of the American College of Cardiology, Vol. 14, No. 1, 1989, p. 209-215.

Research output: Contribution to journalArticle

Stanton, Marshall S. ; Prystowsky, Eric N. ; Fineberg, Naomi S. ; Miles, William M. ; Zipes, Douglas P. ; Heger, James J. / Arrhythmogenic effects of antiarrhythmic drugs : A study of 506 patients treated for ventricular tachycardia or fibrillation. In: Journal of the American College of Cardiology. 1989 ; Vol. 14, No. 1. pp. 209-215.
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