Favorable effects of the optimized drug treatment of heart failure on ventricular arrhythmias.
BACKGROUND
Ventricular arrhythmic events have a strong impact on the mortality of patients with heart failure. The benefits of the optimized drug treatment of heart failure in reducing ventricular arrhythmia have not been well documented yet.


OBJECTIVE
To analyze the effects of the optimized drug treatment of heart failure on ventricular arrhythmia.


METHODS
This is a clinical study with a non-randomized design of 85 consecutive (open cohort) non-selected patients, with a mean age of 63.8+/-12.2 years; 42 were males and 43 were females. All patients had a diagnosis of heart failure (HF), NYHA Functional Class II to IV, EF <or=0.40 and, after treatment optimization, they were followed from January 2002 to May 2004, regarding the ventricular arrhythmia behavior, at admission and at the end of the study.


RESULTS
At the start of the study, 60% of patients presented more than 1,000 ventricular extrasystoles in 24 hours, 100% pairs and 100% nonsustained ventricular tachycardia (NSVT). During a follow-up period of 8 to 27 months (20.0 + 4.8 months) a significant decrease in the total number of ventricular extrasystoles/24 hrs, number of pairs and number of NSVT episodes was observed (p<0.05). The improvement in functional class and performance at the six-minute walk test was also observed. A decrease in hospital admissions was also observed in relation to the period prior to the study inclusion (4.8 hospital admissions/patient/year and at the end of the study, 2.7 hospital admissions/patient/year) (p<0.005).


CONCLUSIONS
The optimized treatment of HF decreased the incidence of ventricular arrhythmias. The improvement in the functional class, physical performance and the decreased number of hospitalizations can be attributed to the optimized treatment of HF.
God
Epotamenides Maria Good
EM
Hospital Vera Cruz, Belo Horizonte, MG, Brasil. epotamenides@uol.com.br
Moreira
Maria da Consolação V
Mda C
Pereira Barretto
Antonio Carlos
AC
D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000503:physiopathology; D001938:Brazil; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D017180:Tachycardia, Ventricular / Q000473:pathology; D013997:Time Factors; D018879:Ventricular Premature Complexes / Q000473:pathology; D016138:Walking / Q000502:physiology
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors