Days Required for 75% Suppression of Ventricular Premature Contractions by Antiarrhythmic Agents Obtained from Continuous In-hospital ECG Monitoring.

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To determine the number of days required to obtain 75% suppression of ventricular premature contractions (VPCs) by antiarrhythmic agents, which was expressed as t1/4, we performed 32 in-hospital continuous all day EGG monitoring trials in four groups of 28 symptomatic patients (ages; 54±20 yearsold) with frequent VPCs. Nine patients had no organic heart disease (group 1, 11 trials), nine had valvular heart disease (group 2, 10 trials), three had dilated cardiomyopathy (group 3, 3 trials) and seven had myocardial infarction within two to four weeks onset (group 4, 8 trials). All patients were monitored by ECG telemetry with an arrhythmia analyzer, which could count hourly and daily VPCs. Class I antiarrhythmic agents were given in 18 trials, class II in two trials and class I+ class II in 12 trials. Plasma concentrations of the antiarrhythmic agents were monitored in 11 trials.In 21 trials, t1/4 could be obtained; ten (91%), six (60%), three (100%) and two trials (25%) in the four groups, respectively (p<0.05). The value of t1/4 in the four groups was 6±6, 7±6, 14±11 and 13±2 days, respectively (mean 8±7 days; N.S.). Immediate response to the initial antiarrhythmic agent administration, expressed as percent VPC count after three hours, correlated significantly with t1/4 (r=0.696, p=0.0006), but ejection fraction, patient's age, control VPC counts or plasma antiarrhythmic agent level did not correlate with t1/4. In conclusion, t1/4 is a useful index for the evaluation of VPC suppression, revealing wide interindividual variations and can be roughly estimated from the immediate response to the initial antiarrhythmic agent administration.
International Heart Journal刊行会の論文

Days Required for 75% Suppression of Ventricular Premature Contractions by Antiarrhythmic Agents Obtained from Continuous In-hospital ECG Monitoring.

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