Amiodarone versus amiodarone and a type IA agent for treatment of patients with rapid ventricular tachycardia

Circulation
F E MarchlinskiM E Josephson

Abstract

Induction of rapid ventricular tachycardia or fibrillation during therapy with amiodarone is associated with an increased risk of sudden death. To determine whether the addition of a type IA antiarrhythmic agent to therapy would improve outcome, 37 patients in whom ventricular tachyarrhythmia of a cycle length less than 350 msec was induced after 14 +/- 2 days of amiodarone were randomly assigned to therapy with amiodarone alone (group 1, 20 patients) or amiodarone plus type IA agent (group 2, 17 patients). Type IA therapy consisted of procainamide in 13 patients and quinidine in four procainamide-intolerant patients. To assess the short-term effects of a type IA agent on inducibility of ventricular tachyarrhythmia, cycle length, and hemodynamic tolerance, 16 of 20 patients in group 1 and all patients in group 2 underwent repeat programmed stimulation after the intravenous administration of procainamide during amiodarone therapy (mean procainamide serum concentration 7.2 +/- 2.0 micrograms/ml). Procainamide prevented induction of sustained arrhythmia in only two of 33 patients. Procainamide increased the cycle length of induced ventricular tachycardia from 283 +/- 30 to 352 +/- 46 msec (p less than .001). After the addition of ...Continue Reading

References

May 1, 1983·Pacing and Clinical Electrophysiology : PACE·F MoradyD S Hess
Dec 1, 1984·Journal of the American College of Cardiology·F E MarchlinskiM E Josephson
Sep 1, 1984·Journal of the American College of Cardiology·S SaksenaR Werres
Dec 1, 1983·Journal of the American College of Cardiology·H L GreeneG B Trobaugh
Jun 1, 1984·The American Journal of Cardiology·B McGovernJ N Ruskin
Sep 1, 1980·The American Journal of Cardiology·A M GreenspanM E Josephson

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Citations

Apr 30, 2003·Journal of Cardiovascular Pharmacology·Deepak HaikerwalAnthony M Dart
Jun 2, 1998·Journal of Cardiovascular Electrophysiology·F Chézalviel-GuilbertJ Weissenburger
Jan 1, 1988·Chest·P R KoweyJ L Stohler
Apr 1, 1996·Journal of Cardiovascular Pharmacology and Therapeutics·N NasirA Pacifico
Jul 5, 2021·JACC. Clinical Electrophysiology·Dan L LiWilliam G Stevenson

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