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Long-Term follow-up in patients with incessant ventricular tachycardia

  • Robert J. Hariman
    Correspondence
    Address for reprints: Robert J. Hariman, MD, Hines Veterans Administration Hospital, Hines, Illinois 60141.
    Affiliations
    From the Cardiology Section, Department of Medicine, University of Illinois College of Medicine Chicago, Illinois, USA

    From the Cardiology Section, Department of Medicine, West Side Veterans Administration Medical Center, Chicago, Illinois, USA
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  • Dayi Hu
    Affiliations
    From the Cardiology Section, Department of Medicine, University of Illinois College of Medicine Chicago, Illinois, USA

    From the Cardiology Section, Department of Medicine, West Side Veterans Administration Medical Center, Chicago, Illinois, USA
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  • Jose L. Gallastegui
    Affiliations
    From the Cardiology Section, Department of Medicine, University of Illinois College of Medicine Chicago, Illinois, USA

    From the Cardiology Section, Department of Medicine, West Side Veterans Administration Medical Center, Chicago, Illinois, USA
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  • Karen J. Beckman
    Affiliations
    From the Cardiology Section, Department of Medicine, University of Illinois College of Medicine Chicago, Illinois, USA

    From the Cardiology Section, Department of Medicine, West Side Veterans Administration Medical Center, Chicago, Illinois, USA
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  • Jerry L. Bauman
    Affiliations
    From the Cardiology Section, Department of Medicine, University of Illinois College of Medicine Chicago, Illinois, USA

    From the Cardiology Section, Department of Medicine, West Side Veterans Administration Medical Center, Chicago, Illinois, USA
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      Abstract

      Seventeen patients with coronary artery disease, idiopathic dilated cardiomyopathy or no organic heart disease who presented with incessant ventricular tachycardia (VT) were studied and followed for a mean period of 51 ± 35 months. In these patients the incessant VT included ≥3 episodes of sustained VT at a rate of ≥120 beats/min and frequent episodes of nonsustained VT over a 24-hour period. No patient had electrolyte disorder, prolonged QT interval, drug-induced arrhythmia or myocardial infarction <2 weeks old. Six patients died within 27 months of follow-up; 4 from sudden death and 2 from acute myocardial infarction. Three of the 11 surviving patients had remission of their VT within 1 week after the diagnosis of incessant VT. In 3 other patients in whom antiarrhythmic drugs were discontinued during follow-up because of adverse effects of the drugs or other medical reasons, 2 were found in remission. In the remaining 5 alive patients, deliberate attempts were made to discontinue the antiarrhythmic drugs; 4 of these patients were found in remission when the drugs were discontinued. Thus, 9 of these patients (53%) with incessant VT had remission over a mean follow-up of 55 ± 34 months after discontinuation of the antiarrhythmic drugs. The probability of remission in patients surviving incessant VT warrants trials of discontinuation of antiarrhythmic drugs in these patients.
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