Prospective long-term ECG study of 100 patients surviving sudden cardiac death
Herms, J.; Siebels, J.; Schneider, M.; Kuck, K.H.
Zeitschrift für Kardiologie 81(12): 673-680
1992
ISSN/ISBN: 0300-5860 PMID: 1492436 Document Number: 390159
One hundred survivors of sudden death were randomized to four groups and treated with Amiodarone, Propafenone and Metoprolol, or were supplied with an automatic implantable cardioverter/defibrillator (AICD, control group). Prospective Holter-monitoring showed that the prognostic significance of the complexity and frequency of ventricular ectopic activity in survivors of sudden cardiac death is relative to the chosen prophylactic antiarrhythmic treatment: Findings in the control group confirm the classical notion that frequent and complex ventricular ectopic activity is predictive for recurrent life-threatening ventricular tachyarrhythmias (relapse) (> or = 25 VES/h, p < 0.05; Lown IVb, just short of statistical significance). Therapy with Amiodarone reduced frequent and complex ventricular ectopic activity as well as the 2-year relapse rate, which was significantly lower than in the control group (AICD: 36%, Amiodarone 12%, p = 0.03). Under Metoprolol the frequency and complexity of ectopic ventricular activity increased, yet the relapse rate was reduced (12%, p = 0.03). Under Propafenone, especially, those patients who showed low frequencies of ventricular ectopic activity were at high risk; the 2-year relapse rate was 28%.