Efficacy of antiarrhythmic drugs in arrhythmogenic right ventricular cardiomyopathy: a report from the North American ARVC Registry.
Objectives: This study sought to examine the efficacy of empiric antiarrhythmic drugs in a rigorously characterized cohort of arrhythmogenic right ventricular cardiomyopathy (ARVC) patients.Background: Antiarrhythmic drugs are important in protecting against ventricular arrhythmias in ARVC, but no s...
| Publicado en: | Journal of the American College of Cardiology (JACC) Vol. 54; no. 7; pp. 609 - 616 |
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| Autores principales: | , , , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Aug2009
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105401428&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105401428 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07351097 20P jtl: Journal of the American College of Cardiology (JACC) issn: 07351097 maglogo: N pubinfo: dt: Aug2009 vid: 54 iid: 7 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 105401428 NLM19660690 2010364231 10.1016/j.jacc.2009.05.020 NLM19660690 PMC2748738 105401428 ppf: 609 ppct: 7 formats: tig: atl: Efficacy of antiarrhythmic drugs in arrhythmogenic right ventricular cardiomyopathy: a report from the North American ARVC Registry. aug: au: Marcus GM Glidden DV Polonsky B Zareba W Smith LM Cannom DS Estes NA 3rd Marcus F Scheinman MM Marcus, Gregory M Glidden, David V Polonsky, Bronislava Zareba, Wojciech Smith, Lisa M Cannom, David S Estes, N A Mark 3rd Marcus, Frank Scheinman, Melvin M affil: Division of Cardiology, Electrophysiology Section, University of California, San Francisco, CA 94143-1354, USA sug: subj: Adrenergic beta-Antagonists Therapeutic Use Antiarrhythmia Agents Therapeutic Use Arrhythmogenic Right Ventricular Dysplasia Complications Tachycardia, Ventricular Prevention and Control Ventricular Fibrillation Prevention and Control Adult Amiodarone Therapeutic Use Arrhythmogenic Right Ventricular Dysplasia Therapy Combined Modality Therapy Cox Proportional Hazards Model Data Collection Defibrillators, Implantable Female Male Middle Age Sotalol Therapeutic Use Tachycardia, Ventricular Etiology Treatment Outcomes Ventricular Fibrillation Etiology Human Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Objectives: This study sought to examine the efficacy of empiric antiarrhythmic drugs in a rigorously characterized cohort of arrhythmogenic right ventricular cardiomyopathy (ARVC) patients.Background: Antiarrhythmic drugs are important in protecting against ventricular arrhythmias in ARVC, but no studies have provided data in a group rigorously screened for the disease.Methods: Antiarrhythmic medicines were examined in all subjects with implantable cardioverter-defibrillators (ICDs) enrolled in the North American ARVC Registry. A Cox proportional hazards model was used to account for time on each drug, and a hierarchical analysis was performed for repeated measures within individuals.Results: Ninety-five patients were studied, with a mean follow-up of 480 +/- 389 days. Fifty-eight (61%) received beta-blockers, and these medicines were not associated with an increased or decreased risk of ventricular arrhythmias. Sotalol was associated with a greater risk of any clinically relevant ventricular arrhythmia as defined by sustained ventricular tachycardia or ICD therapy (hazard ratio [HR]: 2.55, 95% confidence interval [CI]: 1.02 to 6.39, p = 0.045), but this was not statistically significant after adjusting for potential confounders. An increased risk of any ICD shock and first clinically relevant ventricular arrhythmia while on sotalol remained significant after multivariable adjustment. Those on amiodarone (n = 10) had a significantly lower risk of any clinically relevant ventricular arrhythmia (HR: 0.25, 95% CI: 0.07 to 0.95, p = 0.041), a finding that remained significant after multivariable adjustment.Conclusions: In a cohort of well-characterized ARVC subjects, neither beta-blockers nor sotalol seemed to be protective. Evidence from a small number of patients suggests that amiodarone has superior efficacy in preventing ventricular arrhythmias. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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