Five cases of arrhythmogenic left ventricular aneurysm unrelated to coronary occlusion.

Aizawa, Yoshifusa; Murata, MlNORU; Satoh, Minoru; Aizawa, Masami; Suzuki, Kaoru; Kato, Hidenori; Funazaki, Toshikazu; Shibata, Akira; Eguchi, Shoji

doi:10.1253/jcj.50.45

Cited by 26 publications

(8 citation statements)

References 17 publications

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“…The mean age was 53±17 years (range, 13-79); 14 females and 63 males. As the underlying structural heart disease, 24 patients had ischemic heart disease, 16 had arrhythmogenic right ventricular dysplasia, 6 had arrhythmogenic idiopathic left ventricular aneurysm (with normal coronary arteries), 16 4 had hypertrophic cardiomyopathy, 7 had dilated cardiomyopathy, 4 had surgically corrected congenital heart disease, and 2 had other heart diseases. No structural heart disease was present in the remaining 13 patients.…”

Section: Patientsmentioning

confidence: 99%

“…To determine the 'effective' antiarrhythmic drug for VT prevention, all sustained ventricular arrhythmias must be prevented during the whole induction protocol, including up to 3 extrastimuli as well as the isoproterenol infusion, but repetitive ventricular responses (RVR) are allowed to remain up to 5 beats when they were in the same QRS configuration as the clinical VT and up to 12 beats when they were in polymorphic QRS configurations. 16,17 When VT could not be induced during the control state, the determination of EPS-guided therapy was abandoned, and the case was excluded from the study. When no effective antiarrhythmic drug was determined in serial EPS testing, an implantable cardioverter-defibrillator or the antiarrhythmic drug that prolonged the VT cycle length enough to stabilize the hemodynamics was chosen as the follow-up therapy, and the patient was excluded from the study.…”

Section: Electrophysiologic Studymentioning

confidence: 99%

“…For patients with drug-refractory VT, at least 1 drug from each class of Ia, Ib, Ic and III was tried. 16 For the drug assessment by EPS, each antiarrhythmic drug was continued for at least 5 half-lives before the procedure. In patients given amiodarone therapy, 400 mg/day po was taken for 2 weeks and 200 mg/day po for 1 or 2 weeks before the study.…”

Section: Pharmacological Therapymentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] To determine whether an antiarrhythmic drug is effective, all sustained ventricular tachyarrhythmias must be rendered non-inducible. Repetitive ventricular responses were allowed to remain for up to 5 beats when they were in the same QRS configuration as the VT, and up to 12 beats when they were in polymorphic QRS configurations.…”

Section: Criteria For Determination Of Drug Responders During the Drumentioning

confidence: 99%

“…As reported in similar previous studies, these criteria achieved relatively low rates of VT recurrence and sudden cardiac death in comparison with the prognoses of non-drug responders determined during EPS. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] However, the incidence of VT recurrence is not negligible.…”

Section: Criteria For Determination Of Drug Responders During the Drumentioning

confidence: 99%

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Electrophysiologic Parameters to Predict Clinical Recurrence of Ventricular Tachycardia in Patients Under Electrophysiologic Study-Guided Effective Pharmacological Therapy

et al. 1999

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lthough an electrophysiologic study (EPS) is the most reliable method for selecting a suitable treatment for patients with sustained ventricular tachycardia (VT), the effectiveness of antiarrhythmic drugs in preventing VT induction is limited. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Furthermore, clinical VT recurrence has been observed even under EPSguided effective pharmacological therapy and the incidence of such VT recurrence is not low. [3][4][5][6][7][8][9][10][11][12][13][14][15] The reliability of EPS-guided therapy strongly depends on the stimulation protocol and the criteria for the patient response to programmed stimulation at the drug testing. For example, the studies of Mitchell et al, 10,11 which employed some of the most strict criteria for drug efficacy, showed a VT recurrence rate of 15% in 3 years, whereas the ESVEM study, which employed less rigid criteria, showed an arrhythmic event rate >50% in 5 years. 12 This indicates that VT recurrence can be more reliably avoided when stricter criteria are used for the drug assessment in an EPS, although this would reduce the population of patients effectively treated. However, the lowest VT recurrence rate is still 15-20% in 3-5 years. In the present study, electrophysiologic parameters were analyzed in patients with sustained VT who were followed up under treatment with effective antiarrhythmic drugs, which rendered the VT non-inducible, and these parameters were compared between the groups with and without arrhythmic events to identify the electrophysiologic parameters useful for predicting clinical VT recurrence in patients under EPSguided effective pharmacological therapy. Methods PatientsThe study population consisted of 77 of 202 consecutive patients with sustained monomorphic VT who underwent an EPS and who met the following criteria: (1) they had had at least one episode of electrocardiographically documented sustained monomorphic VT, (2) at least 1 antiarJpn Circ J 1999; 63: 674 -680 (Received March 3, 1999; revised manuscript received May 26, 1999; accepted June 1, 1999 Although an electrophysiologic study (EPS) is the most reliable method for selecting the treatment for a patient with sustained ventricular tachycardia (VT), VT recurrence may occur even during EPS-guided effective therapy. Electrophysiologic parameters were compared between patients with and without arrhythmic events under EPSguided effective therapy to identify the predictive parameters of VT recurrence during the clinical course. The study population consisted of 77 consecutive patients with sustained VT who were receiving long-term pharmacological therapy that was demonstrated to be effective by the EPS assessment. The VT induction protocol employed 1-3 extrastimuli and rapid ventricular pacing at 2 right ventricular sites and 1 left ventricular site, and isoproterenol was infused when VT was not induced. To determine the 'effective' antiarrhythmic drug, all sustained ventricular arrhythmias had to be prevented during the whole induction protocol, but repetitive ve...

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Section: Patientsmentioning

confidence: 99%

Section: Electrophysiologic Studymentioning

confidence: 99%

Section: Pharmacological Therapymentioning

confidence: 99%