Efficacy and electrophysiologic effects of encainide for atrioventricular nodal reentrant tachycardia
Identifieur interne : 001218 ( Main/Corpus ); précédent : 001217; suivant : 001219Efficacy and electrophysiologic effects of encainide for atrioventricular nodal reentrant tachycardia
Auteurs : Gerald V. Naccarelli ; Warren M. Jackman ; Masood Akhtar ; Robert L. Rinkenberger ; Karen J. Friday ; Anne H. Dougherty ; Patrick Tchou ; John A. Yeung-Lai-WahSource :
- The American Journal of Cardiology [ 0002-9149 ] ; 1988.
Abstract
To prospectively determine the clinical efficacy and electro-physiologic effects of encainide in atrioventricular nodal reentrant tachycardia (AVNRT), 49 patients refractory to 2.7 ± 1.5 previous antiarrhythmic drug trials underwent electrophysiologic study before and 47 did so after administration of oral encainide (75 to 240 mg/day). Encainide prolonged the minimum atrial pacing cycle length maintaining 1:1 atrioventricular (AV) nodal conduction from 334 ± 55 to 391 ± 55 ms (p = 0.0001). Encainide induced ventriculoatrial (VA) block in 12 patients (25%) and slowed the minimum ventricular pacing cycle length maintaining 1:1 VA conduction from 315 ± 46 to 485 ± 89 ms (p = 0.0001) in the remaining 35 patients. After encainide, AVNRT was not inducible in 32 of 47 patients (68%) primarily because of the effects on retrograde AV nodal conduction. In the remaining 15 (32%) patients, AVNRT remained inducible; however, the tachycardia cycle length slowed from 397 ± 86 to 492 ± 90 ms (p = 0.0001). There was no significant difference in the baseline minimum ventricular pacing cycle length maintaining 1:1 VA conduction in patients whose inducible tachycardia was or was not suppressed.Forty-seven patients were treated for 18.9 ± 12.9 months (range 1 to 50) with oral encainide. Encainide was completely effective in eliminating recurrences of supraventricular tachycardia in 26 of 47 patients (55%) and partially effective in an additional 42%. Recurrences of arrhythmia occurred in 15 of 32 patients (47%) whose inducible tachycardia was suppressed by encainide and 7 of 15 patients (47%) whose inducible tachycardia was not suppressed by encainide (p = not significant).It is concluded that encainide is effective in the treatment of patients with AVNRT. Encainide's primary antiarrhythmic effect is depression of conduction in the retrograde limb of the reentrant circuit. Results of serial electrophysiologic testing with encainide in AVNRT are not predictive of long-term clinical response.
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DOI: 10.1016/0002-9149(88)90013-6
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Efficacy and electrophysiologic effects of encainide for atrioventricular nodal reentrant tachycardia</title><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 Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Jackman, Warren M" sort="Jackman, Warren M" uniqKey="Jackman W" first="Warren M." last="Jackman">Warren M. Jackman</name><affiliation><mods:affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Akhtar, Masood" sort="Akhtar, Masood" uniqKey="Akhtar M" first="Masood" last="Akhtar">Masood Akhtar</name><affiliation><mods:affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><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 Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Friday, Karen J" sort="Friday, Karen J" uniqKey="Friday K" first="Karen J." last="Friday">Karen J. Friday</name><affiliation><mods:affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School 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 Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Tchou, Patrick" sort="Tchou, Patrick" uniqKey="Tchou P" first="Patrick" last="Tchou">Patrick Tchou</name><affiliation><mods:affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Yeung Lai Wah, John A" sort="Yeung Lai Wah, John A" uniqKey="Yeung Lai Wah J" first="John A." last="Yeung-Lai-Wah">John A. Yeung-Lai-Wah</name><affiliation><mods:affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:891157A76B605401D2AA1DC7EC0728F1369CAB23</idno><date when="1988" year="1988">1988</date><idno type="doi">10.1016/0002-9149(88)90013-6</idno><idno type="url">https://api.istex.fr/document/891157A76B605401D2AA1DC7EC0728F1369CAB23/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">001218</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Efficacy and electrophysiologic effects of encainide for atrioventricular nodal reentrant tachycardia</title><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 Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Jackman, Warren M" sort="Jackman, Warren M" uniqKey="Jackman W" first="Warren M." last="Jackman">Warren M. Jackman</name><affiliation><mods:affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Akhtar, Masood" sort="Akhtar, Masood" uniqKey="Akhtar M" first="Masood" last="Akhtar">Masood Akhtar</name><affiliation><mods:affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><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 Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Friday, Karen J" sort="Friday, Karen J" uniqKey="Friday K" first="Karen J." last="Friday">Karen J. Friday</name><affiliation><mods:affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School 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 Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Tchou, Patrick" sort="Tchou, Patrick" uniqKey="Tchou P" first="Patrick" last="Tchou">Patrick Tchou</name><affiliation><mods:affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Yeung Lai Wah, John A" sort="Yeung Lai Wah, John A" uniqKey="Yeung Lai Wah J" first="John A." last="Yeung-Lai-Wah">John A. Yeung-Lai-Wah</name><affiliation><mods:affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School 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">19</biblScope><biblScope unit="page" from="L31">L31</biblScope><biblScope unit="page" to="L36">L36</biblScope></imprint><idno type="ISSN">0002-9149</idno></series><idno type="istex">891157A76B605401D2AA1DC7EC0728F1369CAB23</idno><idno type="DOI">10.1016/0002-9149(88)90013-6</idno><idno type="PII">0002-9149(88)90013-6</idno><idno type="ArticleID">88900136</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">To prospectively determine the clinical efficacy and electro-physiologic effects of encainide in atrioventricular nodal reentrant tachycardia (AVNRT), 49 patients refractory to 2.7 ± 1.5 previous antiarrhythmic drug trials underwent electrophysiologic study before and 47 did so after administration of oral encainide (75 to 240 mg/day). Encainide prolonged the minimum atrial pacing cycle length maintaining 1:1 atrioventricular (AV) nodal conduction from 334 ± 55 to 391 ± 55 ms (p = 0.0001). Encainide induced ventriculoatrial (VA) block in 12 patients (25%) and slowed the minimum ventricular pacing cycle length maintaining 1:1 VA conduction from 315 ± 46 to 485 ± 89 ms (p = 0.0001) in the remaining 35 patients. After encainide, AVNRT was not inducible in 32 of 47 patients (68%) primarily because of the effects on retrograde AV nodal conduction. In the remaining 15 (32%) patients, AVNRT remained inducible; however, the tachycardia cycle length slowed from 397 ± 86 to 492 ± 90 ms (p = 0.0001). There was no significant difference in the baseline minimum ventricular pacing cycle length maintaining 1:1 VA conduction in patients whose inducible tachycardia was or was not suppressed.Forty-seven patients were treated for 18.9 ± 12.9 months (range 1 to 50) with oral encainide. Encainide was completely effective in eliminating recurrences of supraventricular tachycardia in 26 of 47 patients (55%) and partially effective in an additional 42%. Recurrences of arrhythmia occurred in 15 of 32 patients (47%) whose inducible tachycardia was suppressed by encainide and 7 of 15 patients (47%) whose inducible tachycardia was not suppressed by encainide (p = not significant).It is concluded that encainide is effective in the treatment of patients with AVNRT. Encainide's primary antiarrhythmic effect is depression of conduction in the retrograde limb of the reentrant circuit. Results of serial electrophysiologic testing with encainide in AVNRT are not predictive of long-term clinical response.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Gerald V. Naccarelli MD</name><affiliations><json:string>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</json:string></affiliations></json:item><json:item><name>Warren M. Jackman MD</name><affiliations><json:string>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</json:string></affiliations></json:item><json:item><name>Masood Akhtar MD</name><affiliations><json:string>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</json:string></affiliations></json:item><json:item><name>Robert L. Rinkenberger MD</name><affiliations><json:string>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</json:string></affiliations></json:item><json:item><name>Karen J. Friday MD</name><affiliations><json:string>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</json:string></affiliations></json:item><json:item><name>Anne H. Dougherty MD</name><affiliations><json:string>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</json:string></affiliations></json:item><json:item><name>Patrick Tchou MD</name><affiliations><json:string>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</json:string></affiliations></json:item><json:item><name>John A. Yeung-Lai-Wah MB, ChB</name><affiliations><json:string>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</json:string></affiliations></json:item></author><articleId><json:string>88900136</json:string></articleId><language><json:string>eng</json:string></language><abstract>To prospectively determine the clinical efficacy and electro-physiologic effects of encainide in atrioventricular nodal reentrant tachycardia (AVNRT), 49 patients refractory to 2.7 ± 1.5 previous antiarrhythmic drug trials underwent electrophysiologic study before and 47 did so after administration of oral encainide (75 to 240 mg/day). Encainide prolonged the minimum atrial pacing cycle length maintaining 1:1 atrioventricular (AV) nodal conduction from 334 ± 55 to 391 ± 55 ms (p = 0.0001). Encainide induced ventriculoatrial (VA) block in 12 patients (25%) and slowed the minimum ventricular pacing cycle length maintaining 1:1 VA conduction from 315 ± 46 to 485 ± 89 ms (p = 0.0001) in the remaining 35 patients. After encainide, AVNRT was not inducible in 32 of 47 patients (68%) primarily because of the effects on retrograde AV nodal conduction. In the remaining 15 (32%) patients, AVNRT remained inducible; however, the tachycardia cycle length slowed from 397 ± 86 to 492 ± 90 ms (p = 0.0001). There was no significant difference in the baseline minimum ventricular pacing cycle length maintaining 1:1 VA conduction in patients whose inducible tachycardia was or was not suppressed.Forty-seven patients were treated for 18.9 ± 12.9 months (range 1 to 50) with oral encainide. Encainide was completely effective in eliminating recurrences of supraventricular tachycardia in 26 of 47 patients (55%) and partially effective in an additional 42%. Recurrences of arrhythmia occurred in 15 of 32 patients (47%) whose inducible tachycardia was suppressed by encainide and 7 of 15 patients (47%) whose inducible tachycardia was not suppressed by encainide (p = not significant).It is concluded that encainide is effective in the treatment of patients with AVNRT. Encainide's primary antiarrhythmic effect is depression of conduction in the retrograde limb of the reentrant circuit. Results of serial electrophysiologic testing with encainide in AVNRT are not predictive of long-term clinical response.</abstract><qualityIndicators><score>6.122</score><pdfVersion>1.3</pdfVersion><pdfPageSize>576 x 828 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>2004</abstractCharCount><pdfWordCount>3122</pdfWordCount><pdfCharCount>22170</pdfCharCount><pdfPageCount>6</pdfPageCount><abstractWordCount>303</abstractWordCount></qualityIndicators><title>Efficacy and electrophysiologic effects of encainide for atrioventricular nodal reentrant tachycardia</title><pii><json:string>0002-9149(88)90013-6</json:string></pii><genre><json:string>research-article</json:string></genre><host><volume>62</volume><pii><json:string>S0002-9149(00)X0642-X</json:string></pii><editor><json:item><name>Gerald V. Naccarelli</name></json:item><json:item><name>MD</name></json:item><json:item><name>Hein J.J. 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Naccarelli, MD, Division of Cardiology, University of Texas Medical School at Houston, P.O. Box 20708, Houston, Texas 77225.</note><affiliation>Address for reprints: Gerald V. Naccarelli, MD, Division of Cardiology, University of Texas Medical School at Houston, P.O. Box 20708, Houston, Texas 77225.</affiliation><affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</affiliation></author><author><persName><forename type="first">Warren M.</forename><surname>Jackman</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</affiliation></author><author><persName><forename type="first">Masood</forename><surname>Akhtar</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</affiliation></author><author><persName><forename type="first">Robert L.</forename><surname>Rinkenberger</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</affiliation></author><author><persName><forename type="first">Karen J.</forename><surname>Friday</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School 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 Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</affiliation></author><author><persName><forename type="first">Patrick</forename><surname>Tchou</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</affiliation></author><author><persName><forename type="first">John A.</forename><surname>Yeung-Lai-Wah</surname></persName><roleName type="degree">MB, ChB</roleName><affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School 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)X0642-X</idno><meeting><addName>A Symposium: The Use of Encainide in Supraventricular Tachycardias, Bermuda</addName><date>19880603</date><date>19880604</date></meeting><editor><persName>Gerald V. Naccarelli</persName></editor><editor><persName>MD</persName></editor><editor><persName>Hein J.J. Wellens</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">19</biblScope><biblScope unit="page" from="L31">L31</biblScope><biblScope unit="page" to="L36">L36</biblScope></imprint></monogr><idno type="istex">891157A76B605401D2AA1DC7EC0728F1369CAB23</idno><idno type="DOI">10.1016/0002-9149(88)90013-6</idno><idno type="PII">0002-9149(88)90013-6</idno><idno type="ArticleID">88900136</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1988</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>To prospectively determine the clinical efficacy and electro-physiologic effects of encainide in atrioventricular nodal reentrant tachycardia (AVNRT), 49 patients refractory to 2.7 ± 1.5 previous antiarrhythmic drug trials underwent electrophysiologic study before and 47 did so after administration of oral encainide (75 to 240 mg/day). Encainide prolonged the minimum atrial pacing cycle length maintaining 1:1 atrioventricular (AV) nodal conduction from 334 ± 55 to 391 ± 55 ms (p = 0.0001). Encainide induced ventriculoatrial (VA) block in 12 patients (25%) and slowed the minimum ventricular pacing cycle length maintaining 1:1 VA conduction from 315 ± 46 to 485 ± 89 ms (p = 0.0001) in the remaining 35 patients. After encainide, AVNRT was not inducible in 32 of 47 patients (68%) primarily because of the effects on retrograde AV nodal conduction. In the remaining 15 (32%) patients, AVNRT remained inducible; however, the tachycardia cycle length slowed from 397 ± 86 to 492 ± 90 ms (p = 0.0001). There was no significant difference in the baseline minimum ventricular pacing cycle length maintaining 1:1 VA conduction in patients whose inducible tachycardia was or was not suppressed.Forty-seven patients were treated for 18.9 ± 12.9 months (range 1 to 50) with oral encainide. Encainide was completely effective in eliminating recurrences of supraventricular tachycardia in 26 of 47 patients (55%) and partially effective in an additional 42%. Recurrences of arrhythmia occurred in 15 of 32 patients (47%) whose inducible tachycardia was suppressed by encainide and 7 of 15 patients (47%) whose inducible tachycardia was not suppressed by encainide (p = not significant).It is concluded that encainide is effective in the treatment of patients with AVNRT. Encainide's primary antiarrhythmic effect is depression of conduction in the retrograde limb of the reentrant circuit. Results of serial electrophysiologic testing with encainide in AVNRT are not predictive of long-term clinical response.</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>88900136</aid><ce:pii>0002-9149(88)90013-6</ce:pii><ce:doi>10.1016/0002-9149(88)90013-6</ce:doi><ce:copyright type="unknown" year="1988"></ce:copyright></item-info><head><ce:title>Efficacy and electrophysiologic effects of encainide for atrioventricular nodal reentrant tachycardia</ce:title><ce:author-group><ce:author><ce:given-name>Gerald V.</ce:given-name><ce:surname>Naccarelli</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="COR1"><ce:sup loc="post">∗</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF3"><ce:sup loc="post">c</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Warren M.</ce:given-name><ce:surname>Jackman</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF3"><ce:sup loc="post">c</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Masood</ce:given-name><ce:surname>Akhtar</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF3"><ce:sup loc="post">c</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Robert L.</ce:given-name><ce:surname>Rinkenberger</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF3"><ce:sup loc="post">c</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Karen J.</ce:given-name><ce:surname>Friday</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF3"><ce:sup loc="post">c</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Anne H.</ce:given-name><ce:surname>Dougherty</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF3"><ce:sup loc="post">c</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Patrick</ce:given-name><ce:surname>Tchou</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF3"><ce:sup loc="post">c</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>John A.</ce:given-name><ce:surname>Yeung-Lai-Wah</ce:surname><ce:degrees>MB, ChB</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF3"><ce:sup loc="post">c</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="AFF1"><ce:label>a</ce:label><ce:textfn>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</ce:textfn></ce:affiliation><ce:affiliation id="AFF2"><ce:label>b</ce:label><ce:textfn>From the University of Wisconsin Mount Sinai Medical Center, Milwaukee, Wisconsin, USA</ce:textfn></ce:affiliation><ce:affiliation id="AFF3"><ce:label>c</ce:label><ce:textfn>From the University of Oklahoma Health Sciences Center and Veterans Administration Medical Center, Oklahoma City, Oklahoma, USA</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>∗</ce:label><ce:text>Address for reprints: Gerald V. Naccarelli, 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">To prospectively determine the clinical efficacy and electro-physiologic effects of encainide in atrioventricular nodal reentrant tachycardia (AVNRT), 49 patients refractory to 2.7 ± 1.5 previous antiarrhythmic drug trials underwent electrophysiologic study before and 47 did so after administration of oral encainide (75 to 240 mg/day). Encainide prolonged the minimum atrial pacing cycle length maintaining 1:1 atrioventricular (AV) nodal conduction from 334 ± 55 to 391 ± 55 ms (p = 0.0001). Encainide induced ventriculoatrial (VA) block in 12 patients (25%) and slowed the minimum ventricular pacing cycle length maintaining 1:1 VA conduction from 315 ± 46 to 485 ± 89 ms (p = 0.0001) in the remaining 35 patients. After encainide, AVNRT was not inducible in 32 of 47 patients (68%) primarily because of the effects on retrograde AV nodal conduction. In the remaining 15 (32%) patients, AVNRT remained inducible; however, the tachycardia cycle length slowed from 397 ± 86 to 492 ± 90 ms (p = 0.0001). There was no significant difference in the baseline minimum ventricular pacing cycle length maintaining 1:1 VA conduction in patients whose inducible tachycardia was or was not suppressed.</ce:simple-para><ce:simple-para view="all" id="simple-para.0015">Forty-seven patients were treated for 18.9 ± 12.9 months (range 1 to 50) with oral encainide. Encainide was completely effective in eliminating recurrences of supraventricular tachycardia in 26 of 47 patients (55%) and partially effective in an additional 42%. Recurrences of arrhythmia occurred in 15 of 32 patients (47%) whose inducible tachycardia was suppressed by encainide and 7 of 15 patients (47%) whose inducible tachycardia was not suppressed by encainide (p = not significant).</ce:simple-para><ce:simple-para view="all" id="simple-para.0020">It is concluded that encainide is effective in the treatment of patients with AVNRT. Encainide's primary antiarrhythmic effect is depression of conduction in the retrograde limb of the reentrant circuit. Results of serial electrophysiologic testing with encainide in AVNRT are not predictive of long-term clinical response.</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 electrophysiologic effects of encainide for atrioventricular nodal reentrant tachycardia</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Efficacy and electrophysiologic effects of encainide for atrioventricular nodal reentrant tachycardia</title></titleInfo><name type="personal"><namePart type="given">Gerald V.</namePart><namePart type="family">Naccarelli</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</affiliation><description>Address for reprints: Gerald V. Naccarelli, 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">Warren M.</namePart><namePart type="family">Jackman</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Masood</namePart><namePart type="family">Akhtar</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Robert L.</namePart><namePart type="family">Rinkenberger</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karen J.</namePart><namePart type="family">Friday</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School 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 Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Patrick</namePart><namePart type="family">Tchou</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School at Houston, Houston, Texas, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">John A.</namePart><namePart type="family">Yeung-Lai-Wah</namePart><namePart type="termsOfAddress">MB, ChB</namePart><affiliation>From the Electrophysiology Laboratories of the University of Texas Medical School 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">To prospectively determine the clinical efficacy and electro-physiologic effects of encainide in atrioventricular nodal reentrant tachycardia (AVNRT), 49 patients refractory to 2.7 ± 1.5 previous antiarrhythmic drug trials underwent electrophysiologic study before and 47 did so after administration of oral encainide (75 to 240 mg/day). Encainide prolonged the minimum atrial pacing cycle length maintaining 1:1 atrioventricular (AV) nodal conduction from 334 ± 55 to 391 ± 55 ms (p = 0.0001). Encainide induced ventriculoatrial (VA) block in 12 patients (25%) and slowed the minimum ventricular pacing cycle length maintaining 1:1 VA conduction from 315 ± 46 to 485 ± 89 ms (p = 0.0001) in the remaining 35 patients. After encainide, AVNRT was not inducible in 32 of 47 patients (68%) primarily because of the effects on retrograde AV nodal conduction. In the remaining 15 (32%) patients, AVNRT remained inducible; however, the tachycardia cycle length slowed from 397 ± 86 to 492 ± 90 ms (p = 0.0001). There was no significant difference in the baseline minimum ventricular pacing cycle length maintaining 1:1 VA conduction in patients whose inducible tachycardia was or was not suppressed.Forty-seven patients were treated for 18.9 ± 12.9 months (range 1 to 50) with oral encainide. Encainide was completely effective in eliminating recurrences of supraventricular tachycardia in 26 of 47 patients (55%) and partially effective in an additional 42%. Recurrences of arrhythmia occurred in 15 of 32 patients (47%) whose inducible tachycardia was suppressed by encainide and 7 of 15 patients (47%) whose inducible tachycardia was not suppressed by encainide (p = not significant).It is concluded that encainide is effective in the treatment of patients with AVNRT. Encainide's primary antiarrhythmic effect is depression of conduction in the retrograde limb of the reentrant circuit. Results of serial electrophysiologic testing with encainide in AVNRT are not predictive of long-term clinical response.</abstract><relatedItem type="host"><titleInfo><title>The American Journal of Cardiology</title></titleInfo><titleInfo type="abbreviated"><title>AJC</title></titleInfo><name type="conference"><namePart>A Symposium: The Use of Encainide in Supraventricular Tachycardias, Bermuda</namePart><namePart type="date">19880603</namePart><namePart type="date" encoding="w3cdtf">19880604</namePart></name><name type="personal"><namePart>Gerald V. Naccarelli</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>Hein J.J. Wellens</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">19881220</dateIssued></originInfo><identifier type="ISSN">0002-9149</identifier><identifier type="PII">S0002-9149(00)X0642-X</identifier><part><date>19881220</date><detail type="issue"><title>A Symposium: The Use of Encainide in Supraventricular Tachycardias, Bermuda</title></detail><detail type="volume"><number>62</number><caption>vol.</caption></detail><detail type="issue"><number>19</number><caption>no.</caption></detail><extent unit="issue pages"><start>L1</start><end>L84</end></extent><extent unit="pages"><start>L31</start><end>L36</end></extent></part></relatedItem><identifier type="istex">891157A76B605401D2AA1DC7EC0728F1369CAB23</identifier><identifier type="DOI">10.1016/0002-9149(88)90013-6</identifier><identifier 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