Measuring Antiarrhythmic Drug Efficacy by Suppression of Asymptomatic Ventricular Arrhythmias

Editorials1 September 1979Measuring Antiarrhythmic Drug Efficacy by Suppression of Asymptomatic Ventricular ArrhythmiasROGER A. WINKLE, M.D.ROGER A. WINKLE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-91-3-480 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThere is general agreement that patients with the combination of coronary artery disease and frequent and complex ventricular ectopic beats are at high risk of subsequent sudden death (1-5). It is widely hypothesized that suppression of such asymptomatic arrhythmias with drugs can prevent these deaths. This hypothesis stimulates many clinicians to treat asymptomatic ventricular ectopic beats when they are frequent and complex and occur in the patient with coronary heart disease. Recent detailed analyses of ambulatory electrocardiographic recordings have documented a marked short-, intermediate-, and long-term spontaneous variation in the total number of premature ventricular ectopic beats and the occurrence...References1. MOSSDECAMILLAMIETLOWSKIGREENEGOLDSTEINLOCKSLEY AJWWSR. Prognostic grading and significance of ventricular premature beats after recovery from myocardial infarction. Circulation. 1975;51-52(suppl 3):204-10. Google Scholar2. KOTLERTABATZNIKMOWERTOMINAGA MBMS. Prognostic significance of ventricular ectopic beats with respect to sudden death in the late postinfarction period. Circulation. 1973;47:959-66. CrossrefMedlineGoogle Scholar3. VISMARAAMSTERDAMMASON LED. Relation of ventricular arrhythmias in the late hospital phase of acute myocardial infarction to sudden death after hospital discharge. Am J Med. 1975;59:6-12. CrossrefMedlineGoogle Scholar4. RUBERMANWEINBLATTGOLDBERGFRANKSHAPIRO WEJCS. Ventricular premature beats and mortality after myocardial infarction. N Engl J Med. 1977;297:750-7. CrossrefMedlineGoogle Scholar5. SCHULZESTRAUSSPITT RHB. Sudden death in the year following myocardial infarction. Am J Med. 1977;62:192-9. CrossrefMedlineGoogle Scholar6. WINKLE R. Antiarrhythmic drug effect mimicked by spontaneous variability of ventricular ectopy. Circulation. 1978;57:1116-21. CrossrefMedlineGoogle Scholar7. MORGANROTHMICHELSONHOROWITZJOSEPHSONPEARLMANDUNKMAN JELMAW. Limitations of routine long-term electrocardiographic monitoring to assess ventricular ectopic frequency. Circulation. 1978;58:408-14. CrossrefMedlineGoogle Scholar8. WINKLEGRADMANFITZGERALD RAJ. Antiarrhythmic drug effect assessed from ventricular arrhythmia reduction in the ambulatory electrocardiogram and treadmill test: comparison of propranolol, procainamide and quinidine. Am J Cardiol. 1978;42:473-80. CrossrefMedlineGoogle Scholar9. WINKLEMEFFINHARRISON RPD. Long-term tocainide therapy for ventricular arrhythmias. Circulation. 1978;57:1008-16. CrossrefMedlineGoogle Scholar10. WINKLEALDERMANFITZGERALDHARRISON REJD. Treatment of recurrent symptomatic ventricular tachycardia. Ann Intern Med. 1976;85:1-7. LinkGoogle Scholar11. MYERBURGBRIESECONDEMALLONLIBERTHSONCASTELLANOS RFCSRA. Long-term antiarrhythmic therapy in survivors of prehospital cardiac arrest. JAMA. 1977;238:2621-4. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ROGER A. WINKLE, M.D.Affiliations: Cardiology Division Stanford University Medical Center Stanford, California PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEvolution and Revolution in Drug Labeling: Regulation of Antiarrhythmic Drugs by the Food and Drug Administration 1962-1996Use of flecainide acetate in the treatment of premature ventricular contractionsCurrent Problems in the Evaluation and Approval of New Antiarrhythmic AgentsVariability of spontaneous and exercise-induced ventricular arrhythmias in the absence and presence of treatment with acebutolol or quinidineMexiletine for ventricular arrhythmiasSudden death—Definition and epidemiologic considerations 1 September 1979Volume 91, Issue 3Page: 480-482KeywordsArrhythmiaCoronary heart diseaseDrugsElectrocardiographyElectrode recordingStable coronary artery disease ePublished: 1 December 2008 Issue Published: 1 September 1979 PDF downloadLoading ...