[Electrophysiological testing of multiple antiarrhythmic drugs in patients with paroxysmal supraventricular tachycardia after chronic oral administration].
Serial electrophysiological testing of multiple antiarrhythmic drugs was performed in 98 patients with paroxysmal supraventricular tachycardia (WPW syndrome 32, concealed WPW syndrome 46, atrioventricular nodal reentrant tachycardia 20). Of 32 patients with WPW syndrome, twelve patients had atrial fibrillation and atrioventricular reentrant tachycardia. Serial supraventricular tachycardia induction was attempted after chronic oral administration of verapamil (120-320 mg/day, 86 pts), diltiazem (180 mg/day, 10 pts), disopyramide (300-600 mg/day, 27 pts), propafenone (300-600 mg/day, 25 pts), flecainide (100-300 mg/day, 7 pts), SUN 1165 (150-300 mg/day, 10 pts), and combination therapy (18 pts) by using six polar electrode left in the heart in almost all patients. In 96 of 98 patients, one or more drugs prevented induction of SVT. Combination therapy alone was effective in 14 pts. The site of action of verapamil and diltiazem was antegrade and retrograde normal pathway AV conduction in circus movement. The site of action of disopyramide, propafenone, flecainide, SUN 1165 was antegrade and retrograde accessory pathway conduction and retrograde normal pathway conduction. Eighty two pts were successfully followed for 17.7 +/- 9.6 months. In 68 of these 82 pts, PSVT did not recur. Therefore, serial electrophysiological testing proved useful for the selection of prophylactic antiarrhythmic drugs.
Nishino
T
T
Department of Cardiovascular Medicine, Hokkaido University, School of Medicine, Sapporo.
D000284:Administration, Oral; D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D004566:Electrodes; D004594:Electrophysiology / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013617:Tachycardia, Supraventricular / Q000188:drug therapy* / Q000503:physiopathology
D000889:Anti-Arrhythmia Agents