[Prospective long-term ECG study of 100 patients surviving sudden cardiac death].
One hundred survivors of sudden death were randomized to four groups and treated with Amiodarone, Propafenone and Metoprolol, or were supplied with an automatic implantable cardioverter/defibrillator (AICD, control group). Prospective Holter-monitoring showed that the prognostic significance of the complexity and frequency of ventricular ectopic activity in survivors of sudden cardiac death is relative to the chosen prophylactic antiarrhythmic treatment: Findings in the control group confirm the classical notion that frequent and complex ventricular ectopic activity is predictive for recurrent life-threatening ventricular tachyarrhythmias (relapse) (> or = 25 VES/h, p < 0.05; Lown IVb, just short of statistical significance). Therapy with Amiodarone reduced frequent and complex ventricular ectopic activity as well as the 2-year relapse rate, which was significantly lower than in the control group (AICD: 36%, Amiodarone 12%, p = 0.03). Under Metoprolol the frequency and complexity of ectopic ventricular activity increased, yet the relapse rate was reduced (12%, p = 0.03). Under Propafenone, especially, those patients who showed low frequencies of ventricular ectopic activity were at high risk; the 2-year relapse rate was 28%.
Herms
J
J
Abteilung für Kardiologie der II. Medizinischen Klinik, Universitätskrankenhaus Eppendorf, Hamburg.
Siebels
J
J
Schneider
M
M
Kuck
K H
KH
D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D016757:Death, Sudden, Cardiac / Q000209:etiology* / Q000517:prevention & control; D017147:Defibrillators, Implantable; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006352:Heart Ventricles / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use; D008875:Middle Aged; D011405:Propafenone / Q000627:therapeutic use; D017180:Tachycardia, Ventricular / Q000503:physiopathology* / Q000517:prevention & control
D011405:Propafenone; D008790:Metoprolol; D000638:Amiodarone
Prospektive Langzeit-EKG-Untersuchung von 100 Patienten mit überlebtem plötzlichem Herztod.