Abstract
Propranolol and nadolol were used in two groups of patients having ventricular arrhythmias. The two groups were characterised by differences in sympathetic drive. The 10 non-adrenergic patients had idiopathic, monomorphic extrasystoles (isolated with fixed coupling or in pairs or salvoes) arising from the right ventricle or the septum. These extrasystoles were chronic and benign, with a slightly increased daytime frequency (day:night = 1.6). They disappeared on exercise. The nine adrenergic patients had less frequent but more complex polymorphic ventricular extrasystoles, and rapid and irregular tachycardias which were resistant. They occurred predominantly during the day and were associated particularly with stress and exercise. They were either idiopathic, or coexisted with mitral valve prolapse (three cases) or hypertrophic subaortic stenosis (one case) in young patients (mean age, 32 years) who did not have coronary heart disease. Nadolol was more effective than propranolol in controlling the arrhythmia, heart rate, and variations in sinus rhythm in the adrenergic group, while the arrhythmia was not controlled in the non-adrenergic group. Using clinical variables, comparison of the frequency of extrasystoles by day and night, and assessment of the antiarrhythmic effect of beta-blockers, the role of the sympathetic tone in non-ischaemic ventricular arrhythmias may be elucidated.
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- Attuel P., Rosengarten M., Leclercq J. F., Milosevic D., Mugica J., Coumel P. Computer quantitated evaluation of cardiac arrhythmias. Pacing Clin Electrophysiol. 1981 Jan;4(1):23–35. doi: 10.1111/j.1540-8159.1981.tb03671.x. [DOI] [PubMed] [Google Scholar]
- Corday E. Symposium on identification and management of the candidate for sudden cardiac death: introduction. Am J Cardiol. 1977 May 26;39(6):813–815. doi: 10.1016/s0002-9149(77)80032-5. [DOI] [PubMed] [Google Scholar]
- Corr P. B., Gillis R. A. Autonomic neural influences on the dysrhythmias resulting from myocardial infarction. Circ Res. 1978 Jul;43(1):1–9. doi: 10.1161/01.res.43.1.1. [DOI] [PubMed] [Google Scholar]
- Coumel P., Leclercq J. F., Attuel P., Rosengarten M., Milosevic D., Slama R., Bouvrain Y. Tachycardies ventriculaires en salves. Etude électro-physiologique et thérapeutique. Arch Mal Coeur Vaiss. 1980 Feb;73(2):153–164. [PubMed] [Google Scholar]
- Frishman W. Clinical pharmacology of the new beta-adrenergic blocking drugs. Part 9. Nadolol: a new long-acting beta-adrenoceptor blocking drug. Am Heart J. 1980 Jan;99(1):124–128. doi: 10.1016/0002-8703(80)90322-1. [DOI] [PubMed] [Google Scholar]
- Lown B., Tykocinski M., Garfein A., Brooks P. Sleep and ventricular premature beats. Circulation. 1973 Oct;48(4):691–701. doi: 10.1161/01.cir.48.4.691. [DOI] [PubMed] [Google Scholar]
- Mason J. W., Stinson E. B., Harrison D. C. Autonomic nervous system and arrhythmias: studies in the transplanted denervated human heart. Cardiology. 1976;61(1):75–87. doi: 10.1159/000169749. [DOI] [PubMed] [Google Scholar]
- Randall W. C., Euler D. E., Jacobs H. K., Wehrmacher W., Kaye M. P., Hageman G. R. Autonomic neural control of cardiac rhythm: the role of autonomic imbalance in the genesis of cardiac dysrhythmia. Cardiology. 1976;61(1):20–36. doi: 10.1159/000169745. [DOI] [PubMed] [Google Scholar]
- Sonnhag C., Nylander E. Significance and reproducibility of exercise-related idiopathic ventricular arrhythmias. Eur Heart J. 1980 Jun;1(3):183–193. doi: 10.1093/oxfordjournals.eurheartj.a061117. [DOI] [PubMed] [Google Scholar]