Evaluation of Antiarrhythmic Drug Efficacy using Holter Electrocardiographic Technique : SYMPOSIUM ON INDICATION AND SELECTION OF ANTIARRHYTHMIC TREATMENT

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概要

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• This study was performed to investigate spontaneous variability in VPC frequency, to determine standards for distinguishing antiarrhythmic efficacy from the spontaneous variability, and to compare the effectiveness of disopyramide, mexiletine, aprindine, propranolol, and diltiazem. Holter ECG techniques were used for this study and the population studied consisted of 182 patients having more than 1000 VPCs/day. Forty patients had ischemic heart disease, 52 had miscellaneous heart disease and 90 were free of heart disease (idiopathic VPCs). Circadian variability of VPCs can be divided into 4 types: Type D (VPCs increasing during waking hours), Type DN (small VPC changes between waking and sleeping hours), Type N (VPCs increasing during sleeping hours) and Type Ir (irregularly occurring VPCs). The incidence of Type D, DN, N and Ir was 45%, 29%, 12% and 14% , respectively. VPC frequency in the first and second recordings at a 7 up to 21 day interval was highly reproducible (r=0.951). the percent reduction in VPC frequency necessary to distinguish true drug response from spontaneous VPC variability, corresponded to 57% with 95% confidence level, and 67% with 99% confidence level. VPCs were reduced by at least 57% in 19 out of 33 patients (58%) with disopyramide, 9 of 15 (60%) with mexiletine, 11 of 18 (61%) with aprindine, 9 of 24 (38%) with propranolol and 8 of 22 (36%) with diltiazem. Concerning Prop., it is exclusively effective to the Type D VPCs (70%). Consequently, it is important to distinguish true drug effect from spontaneous VPC variability in long-term antiarrhythmic treatment. In this regard, Holter ECG techniques play a very important role in the evaluation.

• 社団法人日本循環器学会の論文
• 1985-03-20

著者

• Yoshikawa Hiroshi

  Department Of Biopharmaceutics Kyoto Pharmaceutical University:exploratory Development Laboratories

• GOTO Yuichiro

  Department of Internal Medicine Keio University

• Goto Yuichiro

  Tokai University School Of Medicine Department Of Internal Medicine

• Tanabe Teruhisa

  Department of cardiology, Tokai University

• TAGAWA Ryusuke

  Department of Cardiology, School of Medicine, Tokai University

• FURUYA Hideo

  Department of Cardiology, School of Medicine, Tokai University

• Ide Michiru

  Department Of Cardiology School Of Medicine Tokai University

• Goto Yuichiro

  Department Of 1st Internal Medicine Tokai University School Of Medicine

• Tanabe Teruhisa

  東海大学 医学部循環器内科

• Tagawa Ryusuke

  Tokai University School of Medicine Department of Internal Medicine

• Ide Michiru

  Department Of Internal Medicine Tokai University School Of Medicine

• Gotoh Yuichiro

  First Department Of Internal Medicine School Of Medicine Tokai University

• Furuya Hideo

  Department Of Internal Medicine Tokai University School Of Medicine. Bohseidai

• Tagawa Ryusuke

  Department Of Cardiology School Of Medicine Tokai University

• Tanabe Teruhisa

  Department Of Cardiology School Of Medicine Tokai University

• Tanabe Teruhisa

  東海大学

• Yoshikawa H

  Graduate School Of Veterinary Medicine Azabu University

• Tagawa Ryusuke

  東海大学

• Yoshikawa Hiroshi

  Department of Applied Physics, Handai Frontier Research Center, and Venture Business Laboratory of Center for Advanced Science and Innovation, Osaka University, Suita, Osaka 565-0871, Japan

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