Propafenone treatment of recurrent ventricular tachycardia: Comparison of continuous electrocardiographic recording and electrophysiologic study in predicting drug efficacy

James J. Heger, Joyce Hubbard, Douglas P. Zipes, William M. Miles, Eric N. Prystowsky

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Propafenone was administered to 29 patients who had multiple episodes of recurrent ventricular tachycardia (VT) or ventricular fibrillation (VF) despite previous antiarrhythmic therapy. All patients had 24-hour continuous electrocardiographic recording and electrophysiologic study in a drug-free control state and while receiving maximum doses of propafenone. During propafenone treatment, the mean frequency of ventricular premature complexes (VPCs) decreased 74% (p <0.05). There was more than an 83% decrease in VPC frequency in 17 of 29 patients, and 11 patients had 99 to 100% decreases. Propafenone prevented VT induction at electrophysiologic study in 6 patients, whereas another 12 patients were judged to have satisfactory electrophysiologic responses on the basis of slower VT rates and absence of hemodynamic compromise during VT. After long-term treatment from 2 to 26 months, 9 patients continued propafenone without evidence of recurrent arrhythmia. Six of these 9 patients had no VT induction at electrophysiologic study while receiving propafenone. The decrease in VPC frequency produced by propafenone was a poor predictor of a successful electrophysiologic study and of long-term therapy. In conclusion, propafenone has potential as an effective antiarrhythmic agent, but better methods to stratify risk for recurrence of VT and VF are needed.

Original languageEnglish (US)
Pages (from-to)40D-44D
JournalThe American journal of cardiology
Volume54
Issue number9
DOIs
StatePublished - 1984

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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