The frequency of asymptomatic disturbances of cardiac rhythm and conduction in middle-aged men

Hinkle, Lawrence E.; Carver, Susan T.; Stevens, M. B.

doi:10.1016/0002-9149(69)90451-2

Cited by 401 publications

(63 citation statements)

References 14 publications

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“…The comparability of the two placebo dosing periods is demonstrated in table 3 8.0 ,ug/ml was achieved during ethmozine dosing. One hour before ethmozine dosing, the mean trough serum level had decreased to 0.1 ± 0.08 ,ug/ml (p < .001 vs peak level).…”

Section: Resultsmentioning

confidence: 97%

Comparative effect of disopyramide and ethmozine in suppressing complex ventricular arrhythmias by use of a double-blind, placebo-controlled, longitudinal crossover design.

Pratt¹,

Young²,

Francis³

et al. 1984

Circulation

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This placebo-controlled, double-blind, longitudinal crossover study compares the efficacy of disopyramide and ethmozine, a new investigational drug, in suppressing frequent (40 or more per hour) ventricular premature depolarizations (VPDs) in 27 patients completing a 37 day protocol. Although both drugs significantly reduced VPDs relative to placebo, ethmozine was a superior antiarrhythmic drug in achieving near-total abolition of VPDs (30% of patients), which was never observed during disopyramide dosing (p < .05). At the 80% VPD reduction level, ethmozine was effective in 56% of all patients compared with an effectiveness in only 22% of patients during disopyramide therapy (p < .05). The mean peak plasma level of ethmozine was 0.66 + 0.8 gg/ml, which significantly fell to a trough level of 0.1 + 0.08 gg/ml (p < .001). Mean peak and trough plasma levels of disopyramide exhibited less fluctuation (2.6 + 0.9 ,ug/ml vs 2.2 0.9 gg/ml). Ethmozine had no effect on the QTC interval, whereas disopyramide prolonged it significantly. Importantly, while disopyramide produced serious side effects in 30% of patients, ethmozine was well tolerated with no statistically significant side effects compared with placebo. Circulation 69, No. 2, 288-297, 1984. EPIDEMIOLOGIC STUDIES in which 12-lead electrocardiograms have been used have documented an increased risk of sudden cardiac death in patients with coronary heart disease who have ventricular premature depolarizations (VPDs). 1-3 Ambulatory electrocardiographic recording has allowed a more systematic and complete quantification of these ventricular arrhythmias that are predictive of sudden cardiac death, especially in patients surviving myocardial infarction.±7The currently available antiarrhythmic drugs include the /3-blockers, some of which have well-defined efficacy for suppressing VPDs.8'9 A number of multi- 288center clinical trials using /3-blockers for patients in the late-hospitalization phase of acute myocardial infarction have shown an overall reduction of sudden cardiac death. I"2 None of these multicenter trials were designed specifically to define the mechanism of this reduction in sudden cardiac death that presumably was a result of preventing sustained ventricular tachycardia and ventricular fibrillation. MethodsProtocol. This randomized, placebo-controlled, doubleblind, crossover study was performed in 33 patients. The occurrence of .40 VPD/hr on at least two consecutive 24 hr ambulatory electrocardiographic recordings (screening) made up the entry criteria. Of the 33 patients randomized, 27 patients (18 men and nine women, ranging in age from 36 to 72 years) completed the protocol and the data from these patients form the basis of this report. Six patients were dropped from the study. Three of these patients, although having the qualifying arrhythmia during screening (_40 VPD/hr), failed to qualify on placebo monitoring. One patient had chronic heart failure that worsened during placebo and ethmozine dosing and was dropped from the study; invasiv...

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Section: Resultsmentioning

confidence: 97%

Comparative effect of disopyramide and ethmozine in suppressing complex ventricular arrhythmias by use of a double-blind, placebo-controlled, longitudinal crossover design.

Pratt¹,

Young²,

Francis³

et al. 1984

Circulation

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“…In a study of middle-aged men, both with and without known heart disease, a 6-h monitor sampling technique identified a 62% incidence of asymptomatic ventricular arrhythmias, more than one half of which were infrequent single PVCs (13). The incidence, frequency, and complexity of ventricular arrhythmias were greater in the presence of known or suspected heart disease, and mortality risk implications were absent in those without heart disease (13,14). In contrast to PVCs and monomorphic patterns of NSVT, polymorphic ventricular tachyarrhythmias in the absence of structural heart disease are indicators of risk (15).…”

Section: Classification By Electrocardiographymentioning

confidence: 94%

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

Zipes¹,

Camm²,

Borggrefe³

et al. 2006

Circulation

1,206

671

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“…Although no patients in the current sample reported palpitations, the possibility of somatic symptoms eliciting stressful diary responses cannot be discounted. Previous studies have reported that male post-MI patients admitted to being aware of irregularities of their heartbeat during holter monitoring when questioned, although their responses were not readily reported (37). Further research is needed evaluate the relationship between psychosocial factors and ventricular ectopy among ambulatory post-MI patients.…”

Section: Discussionmentioning

confidence: 98%

Ventricular ectopy: Impact of self-reported stress after myocardial infarction

Smith¹,

Blumenthal²,

Babyak³

et al. 2007

American Heart Journal

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The frequency of asymptomatic disturbances of cardiac rhythm and conduction in middle-aged men

Cited by 401 publications

References 14 publications

Comparative effect of disopyramide and ethmozine in suppressing complex ventricular arrhythmias by use of a double-blind, placebo-controlled, longitudinal crossover design.

Comparative effect of disopyramide and ethmozine in suppressing complex ventricular arrhythmias by use of a double-blind, placebo-controlled, longitudinal crossover design.

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

Ventricular ectopy: Impact of self-reported stress after myocardial infarction

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