Drug conversion of nonsustained ventricular tachycardia to sustained ventricular tachycardia during serial electrophysiologic studies: Identification of drugs that exacerbate tachycardia and potential mechanisms

Robert L. Rinkenberger, Eric N. Prystowsky, Warren M. Jackman, Gerald V. Naccarelli, James J. Heger, Douglas P. Zipes

Research output: Contribution to journalArticle

117 Citations (Scopus)

Abstract

Eleven of 83 patients who had ventricular tachycardia (VT) and underwent serial electrophysiologic study (EPS) had a more severe VT induced while receiving a particular antiarrhythmic drug as compared to control study. For all patients only nonsustained VT was initiated during control study, while sustained VT occurred during drug testing with disopyramide (2 patients), quinidine (2 patients), amiodarone (4 patients), and encainide (7 patients), although spontaneous arrhythmias appeared well-controlled prior to repeat testing. Pacing techniques used to induce sustained VT were the same as those used in the control study in eight patients and "less aggressive" in three patients. Almost all episodes of sustained VT resulted in substantial hypotension, especially in patients who were taking encainide. Drugs associated with sustained VT increased the median tachycardia cycle length by 112 msec (p < 0.005) but increased the median ventricular effective refractory period by only 30 msec (p < 0.02). Assuming re-entry was responsible for VT, we postulate that drugs facilitated initiation of sustained VT by prolonging activation time but only minimally increasing refractoriness of the tachycardia circuit.

Original languageEnglish
Pages (from-to)177-184
Number of pages8
JournalAmerican Heart Journal
Volume103
Issue number2
DOIs
StatePublished - 1982

Fingerprint

Ventricular Tachycardia
Tachycardia
Pharmaceutical Preparations
Encainide
Disopyramide
Quinidine
Amiodarone
Anti-Arrhythmia Agents
Hypotension
Cardiac Arrhythmias

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Drug conversion of nonsustained ventricular tachycardia to sustained ventricular tachycardia during serial electrophysiologic studies : Identification of drugs that exacerbate tachycardia and potential mechanisms. / Rinkenberger, Robert L.; Prystowsky, Eric N.; Jackman, Warren M.; Naccarelli, Gerald V.; Heger, James J.; Zipes, Douglas P.

In: American Heart Journal, Vol. 103, No. 2, 1982, p. 177-184.

Research output: Contribution to journalArticle

Rinkenberger, Robert L. ; Prystowsky, Eric N. ; Jackman, Warren M. ; Naccarelli, Gerald V. ; Heger, James J. ; Zipes, Douglas P. / Drug conversion of nonsustained ventricular tachycardia to sustained ventricular tachycardia during serial electrophysiologic studies : Identification of drugs that exacerbate tachycardia and potential mechanisms. In: American Heart Journal. 1982 ; Vol. 103, No. 2. pp. 177-184.
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