Ventricular arrhythmias during exercise testing and daily activities in patients with stable angina pectoris before and during Aldisem and penbutolol treatment.
The authors investigated the prevalence of ventricular ectopic activity (VEA) during exercise testing and 24-hour ambulatory Holter monitoring and its relation with ischemic episodes during daily activities before and during therapy with diltiazem and penbutolol in 41 patients with stable and typical angina pectoris. Seven (17%) of the 41 patients had exercise-induced ventricular ectopic activity (EIVA). Premature ventricular complexes (PVC) Lown grade I disappeared in 6 patients on therapy and appeared in another 6 new patients. PVC Lown grade IV A in one patient before therapy changed to Lown grade IV B upon therapy. There was no difference between patients with and without EIVA in the ages, average number of angina onset per day, percentage patients with exercise angina, average functional class, percentage of patients with exercise ST depression, average maximal ST depression, heart rate and systolic blood pressure at peak exercise and duration of exercise. The workload before therapy was similar in the 2 groups, but was significantly greater during therapy in patients without EIVA. During 984 hours of recording, 185 ischemic episodes were detected in 25 patients before therapy, and 111 ischemic episodes in 20 patients during therapy. PVC was observed in 12 (48%) of the 25 patients and in 81 (27%) of the 295 ischemic episodes. VEA during ischemic episodes was observed in patients with and without baseline PVC. The ventricular arrhythmias found were more complex types during ischemic episodes than baseline. Thus, the incidence of VEA in patients with stable and typical angina pectoris was 17% during exercise and 52% during daily activities.(ABSTRACT TRUNCATED AT 250 WORDS)
Catipović-Veselica
K
K
University Department of Medicine, Medical Faculty, University of Zagreb, General Hospital, Osijek, Croatia.
Skrinjarić-Cincar
S
S
Catipović
B
B
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D004110:Diltiazem / Q000627:therapeutic use*; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010394:Penbutolol / Q000627:therapeutic use*
D010394:Penbutolol; D004110:Diltiazem