PMID: 7513876Mar 1, 1994Paper

Results of Holter ECG guided therapy for ventricular arrhythmias: the ESVEM trial

Pacing and Clinical Electrophysiology : PACE
R Lazzara

Abstract

The Electrophysiological Study Versus Electrocardiographic Monitoring (ESVEM) trial randomized 486 patients with spontaneous sustained ventricular tachycardia (VT), ventricular fibrillation (VF) or unmonitored syncope, who manifested reproducibly inducible sustained ventricular arrhythmias by provocative stimulation and 10 or more premature ventricular contractions per hour on Holter monitoring, to two groups treated with pharmacotherapy guided by suppression of stimulation-inducible VT/VF or suppression of spontaneous or exercise induced ventricular arrhythmias. There was no difference over four years of follow-up in the rates of recurrence of arrhythmias, arrhythmic mortality, cardiac mortality, or mortality from any cause between the two groups of patients but more patients (77%) received pharmacotherapy in the group treated on the basis of suppression of spontaneous arrhythmias than the group treated on the basis of electrophysiological study. In this trial, rates of recurrence of arrhythmias were higher (37% at one year and 66% at four years) than generally reported, but cardiac and arrhythmia mortality were comparable or lower than generally reported. Of the seven agents tested, six were sodium channel blockers (imipramin...Continue Reading

References

Sep 1, 1982·The American Journal of Cardiology·T B GraboysR DeSilva
Jun 16, 1983·The New England Journal of Medicine·C D SwerdlowJ W Mason

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Citations

Mar 1, 1996·Progress in Cardiovascular Diseases·J W MasonD Mann
Mar 12, 1999·Annual Review of Medicine·P K Stein, R E Kleiger

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