Proarrhythmic events

Douglas P. Zipes

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Virtually all antiarrhythmic agents can, under certain circumstances, be arrhythmogenic. The expected therapeutic and potentially arrhythmogenic effects of these agents may be altered if there is (1) an increase or decrease in the serum concentration of the antiarrhythmic agent due to interaction with other drugs, renal or hepatic disease or altered pharmacokinetics; (2) an idiosyncratic reaction to the antiarrhythmic agent; (3) an alteration in serum potassium or magnesium concentration; (4) interaction between the antiarrhythmic agent and the autonomic nervous system or between the autonomic nervous system and the heart, or (5) alteration of myocardial performance and the peripheral vascular system by the antiarrhythmic agent. Because of the lack of uniform reporting of data, guidelines have been suggested to evaluate proarrhythmic events. Of 412 patients receiving 1,080 drug trials for treatment of ventricular tachycardia or ventricular fibrillation, proarrhythmic events occurred in 33 patients (8%) and 43 drug trials (4%). The proarrhythmic event occurred more often during treatment for sustained ventricular tachycardia than for ventricular fibrillation or nonsustained ventricular tachycardia. The initial step in treating a proarrhythmic event is to discontinue the offending drug. Further recommendations are based on the nature of the particular arrhythmia.

Original languageEnglish
JournalThe American Journal of Cardiology
Volume61
Issue number2
DOIs
StatePublished - Jan 15 1988

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Ventricular Tachycardia
Autonomic Nervous System
Ventricular Fibrillation
Pharmaceutical Preparations
Serum
Magnesium
Blood Vessels
Cardiac Arrhythmias
Potassium
Research Design
Therapeutics
Pharmacokinetics
Guidelines
Kidney
Liver

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Proarrhythmic events. / Zipes, Douglas P.

In: The American Journal of Cardiology, Vol. 61, No. 2, 15.01.1988.

Research output: Contribution to journalArticle

Zipes, Douglas P. / Proarrhythmic events. In: The American Journal of Cardiology. 1988 ; Vol. 61, No. 2.
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