Requirements of non-pharmacological interventions in the treatment of recurrent sustained ventricular tachycardia.

• AIZAWA Y

  First Department of Internal Medicine and Second Depanment of Surgery

• MURATA MINORU

  First Department of Internal Medicine and Second Depanment of Surgery

• SATOH MASHITO

  First Department of Internal Medicine and Second Depanment of Surgery

• FUNAZAKI TOSHIKAZU

  First Department of Internal Medicine and Second Depanment of Surgery

• MATSUOKA AKIO

  First Department of Internal Medicine and Second Depanment of Surgery

• SHIBATA AKIRA

  First Department of Internal Medicine and Second Depanment of Surgery

• EGUCHI SHOJI

  Niigata University School of Medicine

抄録

Sixty-five patients (pts) with sustained ventricular tachycardia (VT) and 1 patient with symptomatic nonsustained VT were included in this study. Of these, 5 had died before electrophysiologic study (EPS) or determination of effective antiarrhythmic drugs. Inducibility of VT by our protocol varied from 69 to 100% according to underling diseases. Drug efficacy was evaluated by using conventional drugs in all and using flecainide and amiodarone in some. However, more than 50% of pts with inducible VT were found to be resistant to pharmacological therapy. Fourteen of 26 pts with drug-refractory VT, underwent surgical therapy. In all pts, the site of VT origin was determined and VT was either eradicated or clinically controlled in 86% of the patients. Catheter ablation was tried in 9 pts at the earliest activation site of VT or at the site where pace-mapping produced the best result in configuration in the QRS complex as the clinical VT. Prophylactic effect was confirmed in 60% but VT recurred in 3 pts. These VT became responsive to anti-arrhythmic drugs in 2 pts. In thirteen pts who died suddenly during the follow up period, none had adequate antiarrhythmic drugs. One patient died after operation because of residual VT among four different QRS morphologies found preoperatively. In conclusion, the success rate antiarrhythmic drug prophylaxis against VT induction or recurrence did not exceed 50%, therefore non-pharmacological interventions such as surgery or catheter ablation may be required.

収録刊行物

• Jpn Cir J

  Jpn Cir J 54 1340-1348, 1990

  社団法人日本循環器学会

詳細情報

• CRID: 1570291227134981120
• NII論文ID: 110002600333
• NII書誌ID: AA00690731
• ISSN: 00471828
• Web Site: https://search.jamas.or.jp/link/ui/1992087207
• 本文言語コード: en
• データソース種別:
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