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Proarrhythmic responses during electrophysiologic testing.

L N Horowitz, A M Greenspan, A P Rae

    The American Journal of Cardiology
    |April 30, 1987
    PubMed
    Summary
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    Certain antiarrhythmic drugs can provoke dangerous heart rhythm problems, known as proarrhythmia. This study found 16% of drug trials showed proarrhythmic effects in patients with ventricular arrhythmias.

    Area of Science:

    • Cardiology
    • Clinical Electrophysiology

    Background:

    • Antiarrhythmic drugs are crucial for managing cardiac arrhythmias.
    • However, these medications can paradoxically worsen or trigger arrhythmias, an effect termed proarrhythmia.

    Purpose of the Study:

    • To investigate the incidence and characteristics of proarrhythmic responses during antiarrhythmic drug therapy.
    • To evaluate the relationship between proarrhythmia and electrophysiologic parameters.

    Main Methods:

    • Electrophysiologic studies were conducted in 160 patients diagnosed with ventricular tachycardia or ventricular fibrillation.
    • A total of 432 different antiarrhythmic drug regimens were assessed for proarrhythmic effects.

    Main Results:

    • Proarrhythmic responses occurred in 16% (68 of 432) of drug trials.

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  • At least one proarrhythmic event was observed in 32% (51 of 160) of patients.
  • Nonsustained ventricular tachycardia converted to sustained ventricular tachycardia in 17% of trials; hemodynamically stable ventricular tachycardia required cardioversion in 5%.

    • Conclusions:

    • Proarrhythmia is a significant concern in a notable proportion of antiarrhythmic drug trials.
    • Proarrhythmic effects were not correlated with baseline or drug-induced changes in QRS, QT, or JT intervals.