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- Title
Effects of Electrophysiologic-Guided Therapy with Class IA Antiarrhythmic Drugs on the Long-Term Outcome of Patients with Idiopathic Ventricular Fibrillation with or without the Brugada Syndrome.
- Authors
Belhassen, Bernard; Viskin, Sami; Fish, Roman; Glick, Aharon; Setbon, Israel; Eldar, Michael
- Abstract
Introduction: Implantation of a implantable cardioverter defibrillator (ICD) is viewed universally as the ‘gold standard’ therapy for patients with idiopathic ventricular fibrillation (VF). We sought to study the long-term value of electrophysiologic (EP)-guided therapy with Class IA antiarrhythmic drugs in patients with idiopathic VF with or without the Brugada syndrome. Methods and Results: We performed EP studies in 34 consecutive patients who had idiopathic VF with (n = 5) or without (n = 29) the Brugada syndrome. All patients with inducible sustained polymorphic ventricular tachycardia (SPVT) or VF underwent repeated EP evaluation after oral administration of a Class IA antiarrhythmic drug (mainly quinidine). Patients rendered noninducible received this therapy on a long-term basis. SPVTA'F were induced in 27 (79.4%) patients at baseline studies. Class IA drugs effectively prevented induction of SPVTA'F in 26 (96%) patients. Of the 23 patients treated with these medications, no patient died or had a sustained ventricular arrhythmia during a mean follow-up period of 9.1 ± 5.6 years (7 to 20 years in 15 patients). Two deaths occurred in patients without inducible SPVTA'F at baseline studies who had been treated empirically. Conclusion: Our results suggest that EP-guided therapy with Class IA agents is a reasonable, safe, and effective approach for the long-term management of patients with idiopathic VF. A randomized prospective study of EP-guided Class IA therapy in patients with ICDs seems warranted.
- Subjects
IMPLANTABLE cardioverter-defibrillators; BRUGADA syndrome; ELECTROPHYSIOLOGY; MYOCARDIAL depressants; VENTRICULAR tachycardia; QUINIDINE
- Publication
Journal of Cardiovascular Electrophysiology, 1999, Vol 10, Issue 10, p1301
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/j.1540-8167.1999.tb00183.x