The yield of programmed ventricular stimulation in mitral valve prolapse patients with ventricular arrhythmias
A high-risk subset of patients with mitral valve prolapse (MVP) and a predisposition to sudden cardiac death (SCD) has been proposed. We analyzed the results of programmed ventricular stimulation (PVS) in 20 patients with MVP and ventricular arrhythmias (ventricular premature depolarization in 6, ve...
Gespeichert in:
| Veröffentlicht in: | The American heart journal 1985-11, Vol.110 (5), p.970-976 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 976 |
|---|---|
| container_issue | 5 |
| container_start_page | 970 |
| container_title | The American heart journal |
| container_volume | 110 |
| creator | Rosenthal, Mark E Hamer, Angas Gang, Eli S Oseran, Daniel S Mandel, William J Peter, Thomas |
| description | A high-risk subset of patients with mitral valve prolapse (MVP) and a predisposition to sudden cardiac death (SCD) has been proposed. We analyzed the results of programmed ventricular stimulation (PVS) in 20 patients with MVP and ventricular arrhythmias (ventricular premature depolarization in 6, ventricular couplets in 2, nonsustained ventricular tachycardia [VT] in 7, ventricular fibrillation [VF] in 5) and in 12 “normal” control subjects. With the use of an identical stimulation protocol from the right ventricular apex (twice diastolic threshold, three extrastimuli), 9 of 20 MVP patients and 1 of 12 normal subjects had inducible ventricular arrhythmias (
p |
| doi_str_mv | 10.1016/0002-8703(85)90194-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_76448996</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>0002870385901942</els_id><sourcerecordid>76448996</sourcerecordid><originalsourceid>FETCH-LOGICAL-c386t-4b73023b3d8d63895efdb4fe55db3452e987a472470d498b94b88b6098824da93</originalsourceid><addsrcrecordid>eNp9kM1qGzEURkVpSZ20b5CCFqUki0k1Go1-NoFgkrRg6MZZC410p1bQzDiS7OC3r1wbQzZZ6YrvfJfLQeiyJjc1qflPQgitpCDNlWyvFakVq-gHNKuJEhUXjH1EsxPyGZ2n9Fy-nEp-hs4Y4TUVdIbG5QrwzkNweOrxOk5_oxkGcHgLY47eboKJOGU_lCH7acR-xIPP0QS8NWEL-0ow61SGkpdOwq8-r97UTYyrXV4N3qQv6FNvQoKvx_cCPT3cL-e_qsWfx9_zu0VlG8lzxTrRENp0jZOON1K10LuO9dC2rmtYS0FJYZigTBDHlOwU66TsOFFSUuaMai7Qj8Pect7LBlLWg08WQjAjTJukBWdMKsULyA6gjVNKEXq9jn4wcadrovea9d6h3jvUstX_NWtaat-O-zddsXUqHb2W_PsxN8ma0EczWp9OmGQ1Ja0s2O0Bg-Ji6yHqZItEC85HsFm7yb9_xz9BcZqy</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>76448996</pqid></control><display><type>article</type><title>The yield of programmed ventricular stimulation in mitral valve prolapse patients with ventricular arrhythmias</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Rosenthal, Mark E ; Hamer, Angas ; Gang, Eli S ; Oseran, Daniel S ; Mandel, William J ; Peter, Thomas</creator><creatorcontrib>Rosenthal, Mark E ; Hamer, Angas ; Gang, Eli S ; Oseran, Daniel S ; Mandel, William J ; Peter, Thomas</creatorcontrib><description>A high-risk subset of patients with mitral valve prolapse (MVP) and a predisposition to sudden cardiac death (SCD) has been proposed. We analyzed the results of programmed ventricular stimulation (PVS) in 20 patients with MVP and ventricular arrhythmias (ventricular premature depolarization in 6, ventricular couplets in 2, nonsustained ventricular tachycardia [VT] in 7, ventricular fibrillation [VF] in 5) and in 12 “normal” control subjects. With the use of an identical stimulation protocol from the right ventricular apex (twice diastolic threshold, three extrastimuli), 9 of 20 MVP patients and 1 of 12 normal subjects had inducible ventricular arrhythmias (
p<0.05). When more aggressive attempts at ventricular stimulation were used, an additional five MVP patients had positive responses to PVS while no normal subjects did. In the MVP group, the following arrhythmias were induced: nonsustained polymorphic VT in 10, VF in three, and ventricular flutter in one. In all but two patients, triple ventricular extrastimuli were required to elicit this response. Two of the 10 MVP patients undergoing electropharmacologic testing had a successful antiarrhythmic regimen identified, while 13 patients were discharged on empiric antiarrhythmic therapy. At a follow-up of 19.8±13.1 months, all 19 MVP patients who could be contacted were alive. Five patients had symptomatic recurrences at follow-up including two SCD survivors (VT in one and VF in one). In conclusion, it was found that the majority of MVP patients with ventricular arrhythmias have inducible ventricular tachyarrhythmias during PVS and are more susceptible to this than patients without structural heart disease. However, no relationship between the response to PVS and subsequent patient prognosis in the MVP group could be demonstrated. Therefore, PVS appears to be of limited clinical utility in this patient population.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/0002-8703(85)90194-2</identifier><identifier>PMID: 4061272</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adult ; Amiodarone - therapeutic use ; Arrhythmias, Cardiac - complications ; Arrhythmias, Cardiac - physiopathology ; Biological and medical sciences ; Cardiology. Vascular system ; Electrocardiography ; Electrophysiology ; Endocardial and cardiac valvular diseases ; Female ; Heart ; Heart Arrest - etiology ; Heart Ventricles - physiopathology ; Humans ; Male ; Medical sciences ; Mexiletine - therapeutic use ; Middle Aged ; Mitral Valve Prolapse - complications ; Mitral Valve Prolapse - physiopathology ; Procainamide - therapeutic use ; Propafenone ; Propiophenones - therapeutic use ; Propranolol - therapeutic use ; Risk</subject><ispartof>The American heart journal, 1985-11, Vol.110 (5), p.970-976</ispartof><rights>1985</rights><rights>1986 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c386t-4b73023b3d8d63895efdb4fe55db3452e987a472470d498b94b88b6098824da93</citedby><cites>FETCH-LOGICAL-c386t-4b73023b3d8d63895efdb4fe55db3452e987a472470d498b94b88b6098824da93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/0002870385901942$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=8412058$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/4061272$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rosenthal, Mark E</creatorcontrib><creatorcontrib>Hamer, Angas</creatorcontrib><creatorcontrib>Gang, Eli S</creatorcontrib><creatorcontrib>Oseran, Daniel S</creatorcontrib><creatorcontrib>Mandel, William J</creatorcontrib><creatorcontrib>Peter, Thomas</creatorcontrib><title>The yield of programmed ventricular stimulation in mitral valve prolapse patients with ventricular arrhythmias</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>A high-risk subset of patients with mitral valve prolapse (MVP) and a predisposition to sudden cardiac death (SCD) has been proposed. We analyzed the results of programmed ventricular stimulation (PVS) in 20 patients with MVP and ventricular arrhythmias (ventricular premature depolarization in 6, ventricular couplets in 2, nonsustained ventricular tachycardia [VT] in 7, ventricular fibrillation [VF] in 5) and in 12 “normal” control subjects. With the use of an identical stimulation protocol from the right ventricular apex (twice diastolic threshold, three extrastimuli), 9 of 20 MVP patients and 1 of 12 normal subjects had inducible ventricular arrhythmias (
p<0.05). When more aggressive attempts at ventricular stimulation were used, an additional five MVP patients had positive responses to PVS while no normal subjects did. In the MVP group, the following arrhythmias were induced: nonsustained polymorphic VT in 10, VF in three, and ventricular flutter in one. In all but two patients, triple ventricular extrastimuli were required to elicit this response. Two of the 10 MVP patients undergoing electropharmacologic testing had a successful antiarrhythmic regimen identified, while 13 patients were discharged on empiric antiarrhythmic therapy. At a follow-up of 19.8±13.1 months, all 19 MVP patients who could be contacted were alive. Five patients had symptomatic recurrences at follow-up including two SCD survivors (VT in one and VF in one). In conclusion, it was found that the majority of MVP patients with ventricular arrhythmias have inducible ventricular tachyarrhythmias during PVS and are more susceptible to this than patients without structural heart disease. However, no relationship between the response to PVS and subsequent patient prognosis in the MVP group could be demonstrated. Therefore, PVS appears to be of limited clinical utility in this patient population.</description><subject>Adult</subject><subject>Amiodarone - therapeutic use</subject><subject>Arrhythmias, Cardiac - complications</subject><subject>Arrhythmias, Cardiac - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Electrocardiography</subject><subject>Electrophysiology</subject><subject>Endocardial and cardiac valvular diseases</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Arrest - etiology</subject><subject>Heart Ventricles - physiopathology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mexiletine - therapeutic use</subject><subject>Middle Aged</subject><subject>Mitral Valve Prolapse - complications</subject><subject>Mitral Valve Prolapse - physiopathology</subject><subject>Procainamide - therapeutic use</subject><subject>Propafenone</subject><subject>Propiophenones - therapeutic use</subject><subject>Propranolol - therapeutic use</subject><subject>Risk</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1985</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1qGzEURkVpSZ20b5CCFqUki0k1Go1-NoFgkrRg6MZZC410p1bQzDiS7OC3r1wbQzZZ6YrvfJfLQeiyJjc1qflPQgitpCDNlWyvFakVq-gHNKuJEhUXjH1EsxPyGZ2n9Fy-nEp-hs4Y4TUVdIbG5QrwzkNweOrxOk5_oxkGcHgLY47eboKJOGU_lCH7acR-xIPP0QS8NWEL-0ow61SGkpdOwq8-r97UTYyrXV4N3qQv6FNvQoKvx_cCPT3cL-e_qsWfx9_zu0VlG8lzxTrRENp0jZOON1K10LuO9dC2rmtYS0FJYZigTBDHlOwU66TsOFFSUuaMai7Qj8Pect7LBlLWg08WQjAjTJukBWdMKsULyA6gjVNKEXq9jn4wcadrovea9d6h3jvUstX_NWtaat-O-zddsXUqHb2W_PsxN8ma0EczWp9OmGQ1Ja0s2O0Bg-Ji6yHqZItEC85HsFm7yb9_xz9BcZqy</recordid><startdate>198511</startdate><enddate>198511</enddate><creator>Rosenthal, Mark E</creator><creator>Hamer, Angas</creator><creator>Gang, Eli S</creator><creator>Oseran, Daniel S</creator><creator>Mandel, William J</creator><creator>Peter, Thomas</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>198511</creationdate><title>The yield of programmed ventricular stimulation in mitral valve prolapse patients with ventricular arrhythmias</title><author>Rosenthal, Mark E ; Hamer, Angas ; Gang, Eli S ; Oseran, Daniel S ; Mandel, William J ; Peter, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-4b73023b3d8d63895efdb4fe55db3452e987a472470d498b94b88b6098824da93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1985</creationdate><topic>Adult</topic><topic>Amiodarone - therapeutic use</topic><topic>Arrhythmias, Cardiac - complications</topic><topic>Arrhythmias, Cardiac - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Electrocardiography</topic><topic>Electrophysiology</topic><topic>Endocardial and cardiac valvular diseases</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Arrest - etiology</topic><topic>Heart Ventricles - physiopathology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mexiletine - therapeutic use</topic><topic>Middle Aged</topic><topic>Mitral Valve Prolapse - complications</topic><topic>Mitral Valve Prolapse - physiopathology</topic><topic>Procainamide - therapeutic use</topic><topic>Propafenone</topic><topic>Propiophenones - therapeutic use</topic><topic>Propranolol - therapeutic use</topic><topic>Risk</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rosenthal, Mark E</creatorcontrib><creatorcontrib>Hamer, Angas</creatorcontrib><creatorcontrib>Gang, Eli S</creatorcontrib><creatorcontrib>Oseran, Daniel S</creatorcontrib><creatorcontrib>Mandel, William J</creatorcontrib><creatorcontrib>Peter, Thomas</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rosenthal, Mark E</au><au>Hamer, Angas</au><au>Gang, Eli S</au><au>Oseran, Daniel S</au><au>Mandel, William J</au><au>Peter, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The yield of programmed ventricular stimulation in mitral valve prolapse patients with ventricular arrhythmias</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>1985-11</date><risdate>1985</risdate><volume>110</volume><issue>5</issue><spage>970</spage><epage>976</epage><pages>970-976</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>A high-risk subset of patients with mitral valve prolapse (MVP) and a predisposition to sudden cardiac death (SCD) has been proposed. We analyzed the results of programmed ventricular stimulation (PVS) in 20 patients with MVP and ventricular arrhythmias (ventricular premature depolarization in 6, ventricular couplets in 2, nonsustained ventricular tachycardia [VT] in 7, ventricular fibrillation [VF] in 5) and in 12 “normal” control subjects. With the use of an identical stimulation protocol from the right ventricular apex (twice diastolic threshold, three extrastimuli), 9 of 20 MVP patients and 1 of 12 normal subjects had inducible ventricular arrhythmias (
p<0.05). When more aggressive attempts at ventricular stimulation were used, an additional five MVP patients had positive responses to PVS while no normal subjects did. In the MVP group, the following arrhythmias were induced: nonsustained polymorphic VT in 10, VF in three, and ventricular flutter in one. In all but two patients, triple ventricular extrastimuli were required to elicit this response. Two of the 10 MVP patients undergoing electropharmacologic testing had a successful antiarrhythmic regimen identified, while 13 patients were discharged on empiric antiarrhythmic therapy. At a follow-up of 19.8±13.1 months, all 19 MVP patients who could be contacted were alive. Five patients had symptomatic recurrences at follow-up including two SCD survivors (VT in one and VF in one). In conclusion, it was found that the majority of MVP patients with ventricular arrhythmias have inducible ventricular tachyarrhythmias during PVS and are more susceptible to this than patients without structural heart disease. However, no relationship between the response to PVS and subsequent patient prognosis in the MVP group could be demonstrated. Therefore, PVS appears to be of limited clinical utility in this patient population.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>4061272</pmid><doi>10.1016/0002-8703(85)90194-2</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-8703 |
| ispartof | The American heart journal, 1985-11, Vol.110 (5), p.970-976 |
| issn | 0002-8703 1097-6744 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_76448996 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Amiodarone - therapeutic use Arrhythmias, Cardiac - complications Arrhythmias, Cardiac - physiopathology Biological and medical sciences Cardiology. Vascular system Electrocardiography Electrophysiology Endocardial and cardiac valvular diseases Female Heart Heart Arrest - etiology Heart Ventricles - physiopathology Humans Male Medical sciences Mexiletine - therapeutic use Middle Aged Mitral Valve Prolapse - complications Mitral Valve Prolapse - physiopathology Procainamide - therapeutic use Propafenone Propiophenones - therapeutic use Propranolol - therapeutic use Risk |
| title | The yield of programmed ventricular stimulation in mitral valve prolapse patients with ventricular arrhythmias |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T00%3A55%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20yield%20of%20programmed%20ventricular%20stimulation%20in%20mitral%20valve%20prolapse%20patients%20with%20ventricular%20arrhythmias&rft.jtitle=The%20American%20heart%20journal&rft.au=Rosenthal,%20Mark%20E&rft.date=1985-11&rft.volume=110&rft.issue=5&rft.spage=970&rft.epage=976&rft.pages=970-976&rft.issn=0002-8703&rft.eissn=1097-6744&rft.coden=AHJOA2&rft_id=info:doi/10.1016/0002-8703(85)90194-2&rft_dat=%3Cproquest_cross%3E76448996%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=76448996&rft_id=info:pmid/4061272&rft_els_id=0002870385901942&rfr_iscdi=true |