Efficacy and safety of class IC antiarrhythmic agents for the treatment of coexisting supraventricular and ventricular tachycardia
Identifieur interne : 000546 ( Main/Corpus ); précédent : 000545; suivant : 000547Efficacy and safety of class IC antiarrhythmic agents for the treatment of coexisting supraventricular and ventricular tachycardia
Auteurs : Robert L. Rinkenberger ; Gerald V. Naccarelli ; Ellison Berns ; Anne H. DoughertySource :
- The American Journal of Cardiology [ 0002-9149 ] ; 1988.
Abstract
Thirty-three patients with concurrent supraventricular (SVT) and ventricular tachycardia (VT) were treated with class IC antiarrhythmic agents. Twenty-two patients had atrial fibrillation (17 with paroxysmal and 5 with chronic fibrillation), 1 patient had ectopic atrial tachycardia and 11 patients had reentrant paroxysmal SVT (8 with atrioventricular node reentrant tachycardia, 3 with atrioventricular reentrant tachycardia). Of 5 patients with Wolff-Parkinson-White syndrome, 2 had only atrial fibrillation. Six patients had sustained VT and 27 had nonsustained VT. Twenty-nine patients had organic heart disease (16 with coronary artery disease, 8 with cardiomyopathy and 5 with valvular heart disease) and 4 had primary electrical disease. The mean ejection fraction was 40 ± 14% (range 15 to 66%). The study population's arrhythmias were not controlled despite having received 2 to 5 (mean 3.1) previous drug trials. Eighteen patients were referred for treatment of SVT and 15 were referred for treatment of VT (mean symptom duration 107 months). Efficacy was determined in 13 of 33 patients with sustained SVT or VT by programmed electrical stimulation and in 20 of 33 by telemetry and 24-hour Holter response. Twenty-two flecainide and 15 encainide trials were conducted in the 33 patients. Four patients underwent trials with both drugs. Of 33 patients with coexisting SVT and VT, 15 (45%) were controlled with an IC agent alone and 3 continued therapy with an IC agent plus additional therapy (2 drugs, 1 antitachycardia pacing). During the follow-up period (mean 10.4 months), flecainide produced a complete response in 9 patients and encainide in 9 patients. SVT was not controlled in 7 patients and VT was not controlled in 7 patients. One patient had neither arrhythmia controlled. Atrial or ventricular proarrhythmia was seen in 9 of 33 patients (27%) (5 with ventricular and 4 with atrial arrhythmia). Noncardiac side effects were uncommon. Oral class IC agents may be effective therapy for some patients with coexisting VT and SVT of different mechanisms. Patients with such complex arrhythmias should be evaluated carefully because there is a potential for both atrial and ventricular proarrhythmia.
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DOI: 10.1016/0002-9149(88)90507-3
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Efficacy and safety of class IC antiarrhythmic agents for the treatment of coexisting supraventricular and ventricular tachycardia</title><author><name sortKey="Rinkenberger, Robert L" sort="Rinkenberger, Robert L" uniqKey="Rinkenberger R" first="Robert L." last="Rinkenberger">Robert L. Rinkenberger</name><affiliation><mods:affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Naccarelli, Gerald V" sort="Naccarelli, Gerald V" uniqKey="Naccarelli G" first="Gerald V." last="Naccarelli">Gerald V. Naccarelli</name><affiliation><mods:affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Berns, Ellison" sort="Berns, Ellison" uniqKey="Berns E" first="Ellison" last="Berns">Ellison Berns</name><affiliation><mods:affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Dougherty, Anne H" sort="Dougherty, Anne H" uniqKey="Dougherty A" first="Anne H." last="Dougherty">Anne H. Dougherty</name><affiliation><mods:affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:FDB4FEDCB66887C9F2DA46578C39E5EAE37263F6</idno><date when="1988" year="1988">1988</date><idno type="doi">10.1016/0002-9149(88)90507-3</idno><idno type="url">https://api.istex.fr/document/FDB4FEDCB66887C9F2DA46578C39E5EAE37263F6/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000546</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Efficacy and safety of class IC antiarrhythmic agents for the treatment of coexisting supraventricular and ventricular tachycardia</title><author><name sortKey="Rinkenberger, Robert L" sort="Rinkenberger, Robert L" uniqKey="Rinkenberger R" first="Robert L." last="Rinkenberger">Robert L. Rinkenberger</name><affiliation><mods:affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Naccarelli, Gerald V" sort="Naccarelli, Gerald V" uniqKey="Naccarelli G" first="Gerald V." last="Naccarelli">Gerald V. Naccarelli</name><affiliation><mods:affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Berns, Ellison" sort="Berns, Ellison" uniqKey="Berns E" first="Ellison" last="Berns">Ellison Berns</name><affiliation><mods:affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Dougherty, Anne H" sort="Dougherty, Anne H" uniqKey="Dougherty A" first="Anne H." last="Dougherty">Anne H. Dougherty</name><affiliation><mods:affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="ISSN">0002-9149</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1988">1988</date><biblScope unit="volume">62</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="44">44</biblScope><biblScope unit="page" to="55">55</biblScope></imprint><idno type="ISSN">0002-9149</idno></series><idno type="istex">FDB4FEDCB66887C9F2DA46578C39E5EAE37263F6</idno><idno type="DOI">10.1016/0002-9149(88)90507-3</idno><idno type="PII">0002-9149(88)90507-3</idno><idno type="ArticleID">88905073</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-9149</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Thirty-three patients with concurrent supraventricular (SVT) and ventricular tachycardia (VT) were treated with class IC antiarrhythmic agents. Twenty-two patients had atrial fibrillation (17 with paroxysmal and 5 with chronic fibrillation), 1 patient had ectopic atrial tachycardia and 11 patients had reentrant paroxysmal SVT (8 with atrioventricular node reentrant tachycardia, 3 with atrioventricular reentrant tachycardia). Of 5 patients with Wolff-Parkinson-White syndrome, 2 had only atrial fibrillation. Six patients had sustained VT and 27 had nonsustained VT. Twenty-nine patients had organic heart disease (16 with coronary artery disease, 8 with cardiomyopathy and 5 with valvular heart disease) and 4 had primary electrical disease. The mean ejection fraction was 40 ± 14% (range 15 to 66%). The study population's arrhythmias were not controlled despite having received 2 to 5 (mean 3.1) previous drug trials. Eighteen patients were referred for treatment of SVT and 15 were referred for treatment of VT (mean symptom duration 107 months). Efficacy was determined in 13 of 33 patients with sustained SVT or VT by programmed electrical stimulation and in 20 of 33 by telemetry and 24-hour Holter response. Twenty-two flecainide and 15 encainide trials were conducted in the 33 patients. Four patients underwent trials with both drugs. Of 33 patients with coexisting SVT and VT, 15 (45%) were controlled with an IC agent alone and 3 continued therapy with an IC agent plus additional therapy (2 drugs, 1 antitachycardia pacing). During the follow-up period (mean 10.4 months), flecainide produced a complete response in 9 patients and encainide in 9 patients. SVT was not controlled in 7 patients and VT was not controlled in 7 patients. One patient had neither arrhythmia controlled. Atrial or ventricular proarrhythmia was seen in 9 of 33 patients (27%) (5 with ventricular and 4 with atrial arrhythmia). Noncardiac side effects were uncommon. Oral class IC agents may be effective therapy for some patients with coexisting VT and SVT of different mechanisms. Patients with such complex arrhythmias should be evaluated carefully because there is a potential for both atrial and ventricular proarrhythmia.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Robert L. Rinkenberger MD</name><affiliations><json:string>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</json:string></affiliations></json:item><json:item><name>Gerald V. Naccarelli MD</name><affiliations><json:string>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</json:string></affiliations></json:item><json:item><name>Ellison Berns MD</name><affiliations><json:string>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</json:string></affiliations></json:item><json:item><name>Anne H. Dougherty MD</name><affiliations><json:string>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</json:string></affiliations></json:item></author><articleId><json:string>88905073</json:string></articleId><language><json:string>eng</json:string></language><abstract>Thirty-three patients with concurrent supraventricular (SVT) and ventricular tachycardia (VT) were treated with class IC antiarrhythmic agents. Twenty-two patients had atrial fibrillation (17 with paroxysmal and 5 with chronic fibrillation), 1 patient had ectopic atrial tachycardia and 11 patients had reentrant paroxysmal SVT (8 with atrioventricular node reentrant tachycardia, 3 with atrioventricular reentrant tachycardia). Of 5 patients with Wolff-Parkinson-White syndrome, 2 had only atrial fibrillation. Six patients had sustained VT and 27 had nonsustained VT. Twenty-nine patients had organic heart disease (16 with coronary artery disease, 8 with cardiomyopathy and 5 with valvular heart disease) and 4 had primary electrical disease. The mean ejection fraction was 40 ± 14% (range 15 to 66%). The study population's arrhythmias were not controlled despite having received 2 to 5 (mean 3.1) previous drug trials. Eighteen patients were referred for treatment of SVT and 15 were referred for treatment of VT (mean symptom duration 107 months). Efficacy was determined in 13 of 33 patients with sustained SVT or VT by programmed electrical stimulation and in 20 of 33 by telemetry and 24-hour Holter response. Twenty-two flecainide and 15 encainide trials were conducted in the 33 patients. Four patients underwent trials with both drugs. Of 33 patients with coexisting SVT and VT, 15 (45%) were controlled with an IC agent alone and 3 continued therapy with an IC agent plus additional therapy (2 drugs, 1 antitachycardia pacing). During the follow-up period (mean 10.4 months), flecainide produced a complete response in 9 patients and encainide in 9 patients. SVT was not controlled in 7 patients and VT was not controlled in 7 patients. One patient had neither arrhythmia controlled. Atrial or ventricular proarrhythmia was seen in 9 of 33 patients (27%) (5 with ventricular and 4 with atrial arrhythmia). Noncardiac side effects were uncommon. Oral class IC agents may be effective therapy for some patients with coexisting VT and SVT of different mechanisms. Patients with such complex arrhythmias should be evaluated carefully because there is a potential for both atrial and ventricular proarrhythmia.</abstract><qualityIndicators><score>8.316</score><pdfVersion>1.4</pdfVersion><pdfPageSize>576.12 x 791.84 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>2218</abstractCharCount><pdfWordCount>4816</pdfWordCount><pdfCharCount>37039</pdfCharCount><pdfPageCount>12</pdfPageCount><abstractWordCount>337</abstractWordCount></qualityIndicators><title>Efficacy and safety of class IC antiarrhythmic agents for the treatment of coexisting supraventricular and ventricular tachycardia</title><pii><json:string>0002-9149(88)90507-3</json:string></pii><genre><json:string>research-article</json:string></genre><host><volume>62</volume><pii><json:string>S0002-9149(00)X0820-X</json:string></pii><editor><json:item><name>Jeffrey L. 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Rinkenberger, MD, Division of Cardiology, University of Texas Medical School at Houston, P.O. Box 20708, Houston, Texas 77225.</note><affiliation>Address for reprints: Robert L. Rinkenberger, MD, Division of Cardiology, University of Texas Medical School at Houston, P.O. Box 20708, Houston, Texas 77225.</affiliation><affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</affiliation></author><author><persName><forename type="first">Gerald V.</forename><surname>Naccarelli</surname></persName><roleName type="degree">MD</roleName><affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</affiliation></author><author><persName><forename type="first">Ellison</forename><surname>Berns</surname></persName><roleName type="degree">MD</roleName><affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</affiliation></author><author><persName><forename type="first">Anne H.</forename><surname>Dougherty</surname></persName><roleName type="degree">MD</roleName><affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</affiliation></author></analytic><monogr><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="pISSN">0002-9149</idno><idno type="PII">S0002-9149(00)X0820-X</idno><meeting><addName>International Symposium on Supraventricular Arrhythmias: Focus on Flecainide, Paradise Island, Nassau, Bahamas</addName><date>19871023</date><date>19871026</date></meeting><editor><persName>Jeffrey L. Anderson</persName></editor><editor><persName>MD</persName></editor><editor><persName>Edward L. C. Pritchett</persName></editor><editor><persName>MD</persName></editor><imprint><publisher>ELSEVIER</publisher><date type="published" when="1988"></date><biblScope unit="volume">62</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="44">44</biblScope><biblScope unit="page" to="55">55</biblScope></imprint></monogr><idno type="istex">FDB4FEDCB66887C9F2DA46578C39E5EAE37263F6</idno><idno type="DOI">10.1016/0002-9149(88)90507-3</idno><idno type="PII">0002-9149(88)90507-3</idno><idno type="ArticleID">88905073</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1988</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Thirty-three patients with concurrent supraventricular (SVT) and ventricular tachycardia (VT) were treated with class IC antiarrhythmic agents. Twenty-two patients had atrial fibrillation (17 with paroxysmal and 5 with chronic fibrillation), 1 patient had ectopic atrial tachycardia and 11 patients had reentrant paroxysmal SVT (8 with atrioventricular node reentrant tachycardia, 3 with atrioventricular reentrant tachycardia). Of 5 patients with Wolff-Parkinson-White syndrome, 2 had only atrial fibrillation. Six patients had sustained VT and 27 had nonsustained VT. Twenty-nine patients had organic heart disease (16 with coronary artery disease, 8 with cardiomyopathy and 5 with valvular heart disease) and 4 had primary electrical disease. The mean ejection fraction was 40 ± 14% (range 15 to 66%). The study population's arrhythmias were not controlled despite having received 2 to 5 (mean 3.1) previous drug trials. Eighteen patients were referred for treatment of SVT and 15 were referred for treatment of VT (mean symptom duration 107 months). Efficacy was determined in 13 of 33 patients with sustained SVT or VT by programmed electrical stimulation and in 20 of 33 by telemetry and 24-hour Holter response. Twenty-two flecainide and 15 encainide trials were conducted in the 33 patients. Four patients underwent trials with both drugs. Of 33 patients with coexisting SVT and VT, 15 (45%) were controlled with an IC agent alone and 3 continued therapy with an IC agent plus additional therapy (2 drugs, 1 antitachycardia pacing). During the follow-up period (mean 10.4 months), flecainide produced a complete response in 9 patients and encainide in 9 patients. SVT was not controlled in 7 patients and VT was not controlled in 7 patients. One patient had neither arrhythmia controlled. Atrial or ventricular proarrhythmia was seen in 9 of 33 patients (27%) (5 with ventricular and 4 with atrial arrhythmia). Noncardiac side effects were uncommon. Oral class IC agents may be effective therapy for some patients with coexisting VT and SVT of different mechanisms. Patients with such complex arrhythmias should be evaluated carefully because there is a potential for both atrial and ventricular proarrhythmia.</p></abstract></profileDesc><revisionDesc><change when="1988">Published</change></revisionDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: tail"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla" xml:lang="en"><item-info><jid>AJC</jid><aid>88905073</aid><ce:pii>0002-9149(88)90507-3</ce:pii><ce:doi>10.1016/0002-9149(88)90507-3</ce:doi><ce:copyright type="unknown" year="1988"></ce:copyright></item-info><head><ce:title>Efficacy and safety of class IC antiarrhythmic agents for the treatment of coexisting supraventricular and ventricular tachycardia</ce:title><ce:author-group><ce:author><ce:given-name>Robert L.</ce:given-name><ce:surname>Rinkenberger</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="COR1"><ce:sup loc="post">∗</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Gerald V.</ce:given-name><ce:surname>Naccarelli</ce:surname><ce:degrees>MD</ce:degrees></ce:author><ce:author><ce:given-name>Ellison</ce:given-name><ce:surname>Berns</ce:surname><ce:degrees>MD</ce:degrees></ce:author><ce:author><ce:given-name>Anne H.</ce:given-name><ce:surname>Dougherty</ce:surname><ce:degrees>MD</ce:degrees></ce:author><ce:affiliation><ce:textfn>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>∗</ce:label><ce:text>Address for reprints: Robert L. Rinkenberger, MD, Division of Cardiology, University of Texas Medical School at Houston, P.O. Box 20708, Houston, Texas 77225.</ce:text></ce:correspondence></ce:author-group><ce:abstract class="author"><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para view="all" id="simple-para.0010">Thirty-three patients with concurrent supraventricular (SVT) and ventricular tachycardia (VT) were treated with class IC antiarrhythmic agents. Twenty-two patients had atrial fibrillation (17 with paroxysmal and 5 with chronic fibrillation), 1 patient had ectopic atrial tachycardia and 11 patients had reentrant paroxysmal SVT (8 with atrioventricular node reentrant tachycardia, 3 with atrioventricular reentrant tachycardia). Of 5 patients with Wolff-Parkinson-White syndrome, 2 had only atrial fibrillation. Six patients had sustained VT and 27 had nonsustained VT. Twenty-nine patients had organic heart disease (16 with coronary artery disease, 8 with cardiomyopathy and 5 with valvular heart disease) and 4 had primary electrical disease. The mean ejection fraction was 40 ± 14% (range 15 to 66%). The study population's arrhythmias were not controlled despite having received 2 to 5 (mean 3.1) previous drug trials. Eighteen patients were referred for treatment of SVT and 15 were referred for treatment of VT (mean symptom duration 107 months). Efficacy was determined in 13 of 33 patients with sustained SVT or VT by programmed electrical stimulation and in 20 of 33 by telemetry and 24-hour Holter response. Twenty-two flecainide and 15 encainide trials were conducted in the 33 patients. Four patients underwent trials with both drugs. Of 33 patients with coexisting SVT and VT, 15 (45%) were controlled with an IC agent alone and 3 continued therapy with an IC agent plus additional therapy (2 drugs, 1 antitachycardia pacing). During the follow-up period (mean 10.4 months), flecainide produced a complete response in 9 patients and encainide in 9 patients. SVT was not controlled in 7 patients and VT was not controlled in 7 patients. One patient had neither arrhythmia controlled. Atrial or ventricular proarrhythmia was seen in 9 of 33 patients (27%) (5 with ventricular and 4 with atrial arrhythmia). Noncardiac side effects were uncommon. Oral class IC agents may be effective therapy for some patients with coexisting VT and SVT of different mechanisms. Patients with such complex arrhythmias should be evaluated carefully because there is a potential for both atrial and ventricular proarrhythmia.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Efficacy and safety of class IC antiarrhythmic agents for the treatment of coexisting supraventricular and ventricular tachycardia</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Efficacy and safety of class IC antiarrhythmic agents for the treatment of coexisting supraventricular and ventricular tachycardia</title></titleInfo><name type="personal"><namePart type="given">Robert L.</namePart><namePart type="family">Rinkenberger</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</affiliation><description>Address for reprints: Robert L. Rinkenberger, MD, Division of Cardiology, University of Texas Medical School at Houston, P.O. Box 20708, Houston, Texas 77225.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Gerald V.</namePart><namePart type="family">Naccarelli</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ellison</namePart><namePart type="family">Berns</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Anne H.</namePart><namePart type="family">Dougherty</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the University of Texas Health Science Center at Houston, Houston, Texas, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1988</dateIssued><copyrightDate encoding="w3cdtf">1988</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Thirty-three patients with concurrent supraventricular (SVT) and ventricular tachycardia (VT) were treated with class IC antiarrhythmic agents. Twenty-two patients had atrial fibrillation (17 with paroxysmal and 5 with chronic fibrillation), 1 patient had ectopic atrial tachycardia and 11 patients had reentrant paroxysmal SVT (8 with atrioventricular node reentrant tachycardia, 3 with atrioventricular reentrant tachycardia). Of 5 patients with Wolff-Parkinson-White syndrome, 2 had only atrial fibrillation. Six patients had sustained VT and 27 had nonsustained VT. Twenty-nine patients had organic heart disease (16 with coronary artery disease, 8 with cardiomyopathy and 5 with valvular heart disease) and 4 had primary electrical disease. The mean ejection fraction was 40 ± 14% (range 15 to 66%). The study population's arrhythmias were not controlled despite having received 2 to 5 (mean 3.1) previous drug trials. Eighteen patients were referred for treatment of SVT and 15 were referred for treatment of VT (mean symptom duration 107 months). Efficacy was determined in 13 of 33 patients with sustained SVT or VT by programmed electrical stimulation and in 20 of 33 by telemetry and 24-hour Holter response. Twenty-two flecainide and 15 encainide trials were conducted in the 33 patients. Four patients underwent trials with both drugs. Of 33 patients with coexisting SVT and VT, 15 (45%) were controlled with an IC agent alone and 3 continued therapy with an IC agent plus additional therapy (2 drugs, 1 antitachycardia pacing). During the follow-up period (mean 10.4 months), flecainide produced a complete response in 9 patients and encainide in 9 patients. SVT was not controlled in 7 patients and VT was not controlled in 7 patients. One patient had neither arrhythmia controlled. Atrial or ventricular proarrhythmia was seen in 9 of 33 patients (27%) (5 with ventricular and 4 with atrial arrhythmia). Noncardiac side effects were uncommon. Oral class IC agents may be effective therapy for some patients with coexisting VT and SVT of different mechanisms. Patients with such complex arrhythmias should be evaluated carefully because there is a potential for both atrial and ventricular proarrhythmia.</abstract><relatedItem type="host"><titleInfo><title>The American Journal of Cardiology</title></titleInfo><titleInfo type="abbreviated"><title>AJC</title></titleInfo><name type="conference"><namePart>International Symposium on Supraventricular Arrhythmias: Focus on Flecainide, Paradise Island, Nassau, Bahamas</namePart><namePart type="date">19871023</namePart><namePart type="date" encoding="w3cdtf">19871026</namePart></name><name type="personal"><namePart>Jeffrey L. Anderson</namePart><role><roleTerm type="text">editor</roleTerm></role></name><name type="personal"><namePart>MD</namePart><role><roleTerm type="text">editor</roleTerm></role></name><name type="personal"><namePart>Edward L. C. Pritchett</namePart><role><roleTerm type="text">editor</roleTerm></role></name><name type="personal"><namePart>MD</namePart><role><roleTerm type="text">editor</roleTerm></role></name><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">19880825</dateIssued></originInfo><identifier type="ISSN">0002-9149</identifier><identifier type="PII">S0002-9149(00)X0820-X</identifier><part><date>19880825</date><detail type="issue"><title>International Symposium on Supraventricular Arrhythmias: Focus on Flecainide, Paradise Island, Nassau, Bahamas</title></detail><detail type="volume"><number>62</number><caption>vol.</caption></detail><detail type="issue"><number>6</number><caption>no.</caption></detail><extent unit="issue pages"><start>1</start><end>67</end></extent><extent unit="pages"><start>44</start><end>55</end></extent></part></relatedItem><identifier type="istex">FDB4FEDCB66887C9F2DA46578C39E5EAE37263F6</identifier><identifier type="DOI">10.1016/0002-9149(88)90507-3</identifier><identifier type="PII">0002-9149(88)90507-3</identifier><identifier type="ArticleID">88905073</identifier><recordInfo><recordContentSource>ELSEVIER</recordContentSource></recordInfo></mods></metadata><enrichments></enrichments><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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