Multicenter survey on the validity of the CD-ROM guideline for antiarrhythmic drug therapy produced by the Japanese Circulation Society and the Japanese Society on Electrocardiology: preliminary report of the survey of the Japanese guideline for Arrhythmia Management By Individual Therapy (J-GAMBIT).
BACKGROUND
A multicenter investigational survey (Japanese Guideline for Arrhythmia Management By Individual Therapy) was conducted to evaluate the validity of using CD-ROM guidelines vs physician choice for the selection of antiarrhythmic drugs.


RESULTS
Patients with paroxysmal atrial fibrillation (PAF, n=274) or premature ventricular contractions (PVC, n=216) were enrolled. The rate of concordance for drug selection between the treating physician and the CD-ROM was 216 of 274 patients (78.8%) with PAF. Of these, 168 (61.3%) were concordant for first-line agents and the remaining 48 (17.5%) were concordant for second-line agents. The concordance for the treatment of PVC was 154/216 cases (71.3%). Of these, 106 (49.1%) were concordant for first-line agents and the remaining 48 (22.2%) were concordant for second-line agents. Nonconcordance for PAF therapy was more likely to occur for patients with underlying heart disease (p<0.05), depressed cardiac function (p<0.001), and with more frequent ECG abnormalities and renal dysfunction. These differences were not seen in patients with PVC.


CONCLUSIONS
The CD-ROM guidelines appear to be valid in the selection of antiarrhythmic drugs for both PAF and PVC, but their usefulness is influenced by the patient's clinical characteristics.
Katoh
Takao
T
Department of Internal Medicine, Nippon Medical School, Tokyo, Japan. tkkt@nms.ac.jp
Ohara
Toshihiko
T
Ogawa
Satoshi
S
Kodama
Itsuo
I
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D016251:CD-ROM; D003625:Data Collection; D004562:Electrocardiography; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012955:Societies, Medical; D018879:Ventricular Premature Complexes / Q000188:drug therapy*
D000889:Anti-Arrhythmia Agents