Quinidine-Responsive Polymorphic Ventricular Tachycardia in Patients With Coronary Heart Disease
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- Sami Viskin
- Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Israel (S.V., E.C., D.V., A. Hochstadt, A. Halkin, O.T-B., O.H., B.B., R.R.).
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- Ehud Chorin
- Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Israel (S.V., E.C., D.V., A. Hochstadt, A. Halkin, O.T-B., O.H., B.B., R.R.).
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- Dana Viskin
- Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Israel (S.V., E.C., D.V., A. Hochstadt, A. Halkin, O.T-B., O.H., B.B., R.R.).
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- Aviram Hochstadt
- Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Israel (S.V., E.C., D.V., A. Hochstadt, A. Halkin, O.T-B., O.H., B.B., R.R.).
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- Amir Halkin
- Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Israel (S.V., E.C., D.V., A. Hochstadt, A. Halkin, O.T-B., O.H., B.B., R.R.).
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- Oholi Tovia-Brodie
- Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Israel (S.V., E.C., D.V., A. Hochstadt, A. Halkin, O.T-B., O.H., B.B., R.R.).
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- John K. Lee
- St Luke’s Hospital Mid America Heart Institute, Kansas City, MO (J.K.L.).
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- Elad Asher
- Assuta Ashdod University Hospital, Ashdod, Israel (E.A., A.L.-F.).
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- Avishag Laish-Farkash
- Assuta Ashdod University Hospital, Ashdod, Israel (E.A., A.L.-F.).
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- Guy Amit
- Soroka Medical Center and Beer-Sheva University of the Negev, Israel (G.A.).
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- Ofer Havakuk
- Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Israel (S.V., E.C., D.V., A. Hochstadt, A. Halkin, O.T-B., O.H., B.B., R.R.).
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- Bernard Belhassen
- Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Israel (S.V., E.C., D.V., A. Hochstadt, A. Halkin, O.T-B., O.H., B.B., R.R.).
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- Raphael Rosso
- Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Israel (S.V., E.C., D.V., A. Hochstadt, A. Halkin, O.T-B., O.H., B.B., R.R.).
説明
<jats:sec> <jats:title>Background:</jats:title> <jats:p>Polymorphic ventricular tachycardia (VT) without QT prolongation is well described in patients without structural heart disease (mainly idiopathic ventricular fibrillation and Brugada syndrome) and in patients with acute ST-elevation myocardial infarction.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>Retrospective study of patients with polymorphic VT related to coronary artery disease, but without evidence of acute myocardial ischemia.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>The authors identified 43 patients in whom polymorphic VT developed within days of an otherwise uncomplicated myocardial infarction or coronary revascularization procedure. The polymorphic VT events were invariably triggered by extrasystoles with short (364±36 ms) coupling interval. Arrhythmic storms (4–16 events of polymorphic VT deteriorating to ventricular fibrillation) occurred in 23 (53%) patients. These arrhythmic storms were always refractory to conventional antiarrhythmic therapy, including intravenous amiodarone, but invariably responded to quinidine therapy. In-hospital mortality was 17% for patients with arrhythmic storm. Patients treated with quinidine invariably survived to hospital discharge. During long-term follow-up (of 5.6±6 years; range, 1 month to 18 years), 3 (16%) of patients discharged without quinidine developed recurrent polymorphic VT. There were no recurrent arrhythmias during quinidine therapy</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>Arrhythmic storm with recurrent polymorphic VT in patients with coronary disease responds to quinidine therapy when other antiarrhythmic drugs (including intravenous amiodarone) fail.</jats:p> </jats:sec>
収録刊行物
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- Circulation
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Circulation 139 (20), 2304-2314, 2019-05-14
Ovid Technologies (Wolters Kluwer Health)