| 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. |
| Author(s) | Belhassen B, Viskin S, Fish R, Glick A, Setbon I, Eldar M |
| Institution | Department of Cardiology, Tel-Aviv Sourasky Medical Center, Israel. belhasen@ccsg.tau.ac.il |
| Source | J Cardiovasc Electrophysiol 1999 Oct; 10(10):1301-12. |
| MeSH | Adolescent
Adult
Aged
Anti-Arrhythmia Agents
Bundle-Branch Block
Cohort Studies
Electrocardiography
Female
Follow-Up Studies
Humans
Male
Middle Aged
Quinidine
Syndrome
Time Factors
Treatment Outcome
Ventricular Fibrillation
|
| 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. SPVT/VF were induced in 27 (79.4%) patients at baseline studies. Class IA drugs effectively prevented induction of SPVT/VF 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 SPVT/VF 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. |
| Language | eng |
| Pub Type(s) | Journal Article
|
| PubMed ID | 10515552 |
