Key result
The use of all classes of antiarrhythmic agents at the time of ICD implantation decreased significantly from 61% in 1987 to 24% in 1991 (P < 0.05).
Why the study?
Did the use of antiarrhythmic drugs change over time in patients receiving ICDs for VT/VF between 1987 and 1991?
Observational (n=25,450)
Did the use of antiarrhythmic drugs change over time in patients receiving ICDs for VT/VF between 1987 and 1991?
There was a significant decline in the use of antiarrhythmic drugs (except beta blockers) at the time of ICD implantation between 1987 and 1991.
Answers are grounded in this paper and cite their sources.
Supports reduced antiarrhythmic reliance at ICD implant; leaves open relevance to contemporary practice.
Widespread use of implantable cardiovertfir defibrillators (ICDs) for the treatment of ventricular tachycardia (VT) and ventricular fibrillation (VF) occurred in the late 1980s and early 1990s. Additionally, there has been increasing appreciation during this time for both the lack of efficacy and praarrhythmic activity of antiarrhythmic drugs to treat these cardiac arrhythmias. We evaluated the use of antiarrhythmic drugs from 1987 to 1991 (5‐year period) at the time of ICD implantation in 25,450 patients. The use of all classes of antiarrhythmic agents decreased from 61% to 24% during this time period (P < 0.05), In addition, there was a significant reduction in antiarrhythmic agent use for each drug class (P < 0.05) with the exception of Class II agents (beta blockers). These changes in drug use occurred independent of any changes in age, sex, ejection fraction, prevalence of coronary artery disease, or type of ventricular arrhythmia (VT vs VF).
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Sperry et al. (1996) conducted an observational in Ventricular tachycardia and ventricular fibrillation requiring ICD (n=25,450). ICD implantation over time (1991 vs 1987) vs. Historical baseline (1987) was evaluated on Use of all classes of antiarrhythmic agents at the time of ICD implantation (p=<0.05). The use of all classes of antiarrhythmic agents at the time of ICD implantation decreased significantly from 61% in 1987 to 24% in 1991 (P < 0.05).
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