[Arrhythmogenic effect of ajmaline on the atrial level].
The aim of this study was to determine whether an antiarrhythmic, Ajmaline, could have proarrhythmic effects on the atrium and to compare the results with those of other antiarrhythmic drugs. A total of 1950 patients without cardiac failure or recent (less than 6 weeks) myocardial infarction were given 1 mg/kg of Ajmaline intravenously during electrophysiological investigation. A proarrhythmic effect was defined as the occurrence of supraventricular tachycardia (SVT) in a patient without this arrhythmia before the test or the facilitation of its induction. Fifty five patients developed SVT (mainly atrial tachyarrhythmias: 48 cases, and some junctional tachycardia: 7 cases) which occurred spontaneously in 22 patients and during fixed atrial pacing in 33 patients. Fifteen patients developed ventricular tachycardia (VT). The predisposing factors for the development of SVT were: a previous history suggesting spontaneous SVT (28 patients; 51 p. 100); sinoatrial block (14 patients--the only abnormality in 10 cases). Seventeen patients had none of these factors but 8 had known cardiac pathology and the other 9 were relatively elderly patients (79 years). Twelve of the patients developing VT had known cardiac disease, bundle branch block in 12 cases and previous VT in 6 cases. In conclusion, proarrhythmic effects of Ajmaline are infrequent if its contraindications are respected, but they do exist at both atrial (2.8 p. 100) and ventricular levels (0.8 p. 100): the risk factors are comparable: previous spontaneous arrhythmias or ECG changes (SA block at the atrial and bundle branch block at the ventricular level).
Brembilla-Perrot
B
B
Clinique des maladies cardio-vasculaires, CHU de Brabois, Vandoeuvre-Lés-Nancy, France.
al Ammar
A
A
Terrier de la Chaise
A
A
Cherrier
F
F
Pernot
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000404:Ajmaline / Q000008:administration & dosage* / Q000009:adverse effects; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects; D003327:Coronary Disease / Q000188:drug therapy*; D004558:Electric Stimulation; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D013617:Tachycardia, Supraventricular / Q000139:chemically induced* / Q000188:drug therapy
D000889:Anti-Arrhythmia Agents; D000404:Ajmaline
Etude de l'effet arythmogène de l'ajmaline à l'étage auriculaire.