Skip to main content
British Heart Journal logoLink to British Heart Journal
. 1985 Apr;53(4):412–416. doi: 10.1136/hrt.53.4.412

Improved survival with amiodarone in patients with hypertrophic cardiomyopathy and ventricular tachycardia.

W J McKenna, C M Oakley, D M Krikler, J F Goodwin
PMCID: PMC481782  PMID: 4039188

Abstract

The effect of amiodarone on survival was assessed in patients with hypertrophic cardiomyopathy and ventricular tachycardia in a drug trial with historical controls. During 1976 and 1977, 24 hour (seven) or 48 hour (79) electrocardiographic monitoring was performed in 86 consecutive patients; 24 had ventricular tachycardia and received conventional antiarrhythmic agents. Nineteen clinical, echocardiographic, and haemodynamic features were assessed. Seven patients died suddenly during follow up of three years; of these, five had continued to have ventricular tachycardia and two had no documented ventricular tachycardia. During 1978 and 1979, ventricular tachycardia was detected during 48 hour electrocardiographic monitoring in 21 of the next 82 consecutive patients with hypertrophic cardiomyopathy. They received amiodarone (150-400 mg/day, median 300); ventricular tachycardia was suppressed in all during repeat 48 hour electrocardiographic examination. Two patients died suddenly during a three year follow up, but neither belonged to the amiodarone treated group with ventricular tachycardia. The clinical and haemodynamic variables were similar in patients taking amiodarone and conventional agents. The fact that control of ventricular arrhythmia with amiodarone is significantly associated with improved survival suggests that amiodarone may prevent sudden death in patients with hypertrophic cardiomyopathy and ventricular tachycardia.

Full text

PDF
412

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Canedo M. I., Frank M. J., Abdulla A. M. Rhythm disturbances in hypertrophic cardiomyopathy: prevalence, relation to symptoms and management. Am J Cardiol. 1980 Apr;45(4):848–855. doi: 10.1016/0002-9149(80)90131-9. [DOI] [PubMed] [Google Scholar]
  2. Frank S., Braunwald E. Idiopathic hypertrophic subaortic stenosis. Clinical analysis of 126 patients with emphasis on the natural history. Circulation. 1968 May;37(5):759–788. doi: 10.1161/01.cir.37.5.759. [DOI] [PubMed] [Google Scholar]
  3. Ingham R. E., Rossen R. M., Goodman D. J., Harrison D. C. Treadmill arrhythmias in patients with idiopathic hypertrophic subaortic stenosis. Chest. 1975 Dec;68(6):759–764. doi: 10.1378/chest.68.6.759. [DOI] [PubMed] [Google Scholar]
  4. Maron B. J., Roberts W. C., Edwards J. E., McAllister H. A., Jr, Foley D. D., Epstein S. E. Sudden death in patients with hypertrophic cardiomyopathy: characterization of 26 patients with functional limitation. Am J Cardiol. 1978 May 1;41(5):803–810. doi: 10.1016/0002-9149(78)90717-8. [DOI] [PubMed] [Google Scholar]
  5. Maron B. J., Savage D. D., Wolfson J. K., Epstein S. E. Prognostic significance of 24 hour ambulatory electrocardiographic monitoring in patients with hypertrophic cardiomyopathy: a prospective study. Am J Cardiol. 1981 Aug;48(2):252–257. doi: 10.1016/0002-9149(81)90604-4. [DOI] [PubMed] [Google Scholar]
  6. McKenna W. J., England D., Doi Y. L., Deanfield J. E., Oakley C., Goodwin J. F. Arrhythmia in hypertrophic cardiomyopathy. I: Influence on prognosis. Br Heart J. 1981 Aug;46(2):168–172. doi: 10.1136/hrt.46.2.168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. McKenna W. J., Goodwin J. F. The natural history of hypertrophic cardiomyopathy. Curr Probl Cardiol. 1981 Jul;6(4):1–26. doi: 10.1016/0146-2806(81)90015-3. [DOI] [PubMed] [Google Scholar]
  8. McKenna W. J., Harris L., Perez G., Krikler D. M., Oakley C., Goodwin J. F. Arrhythmia in hypertrophic cardiomyopathy. II: Comparison of amiodarone and verapamil in treatment. Br Heart J. 1981 Aug;46(2):173–178. doi: 10.1136/hrt.46.2.173. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. McKenna W. J., Harris L., Rowland E., Kleinebenne A., Krikler D. M., Oakley C. M., Goodwin J. F. Amiodarone for long-term management of patients with hypertrophic cardiomyopathy. Am J Cardiol. 1984 Oct 1;54(7):802–810. doi: 10.1016/s0002-9149(84)80212-x. [DOI] [PubMed] [Google Scholar]
  10. McKenna W., Deanfield J., Faruqui A., England D., Oakley C., Goodwin J. Prognosis in hypertrophic cardiomyopathy: role of age and clinical, electrocardiographic and hemodynamic features. Am J Cardiol. 1981 Mar;47(3):532–538. doi: 10.1016/0002-9149(81)90535-x. [DOI] [PubMed] [Google Scholar]
  11. Savage D. D., Seides S. F., Maron B. J., Myers D. J., Epstein S. E. Prevalence of arrhythmias during 24-hour electrocardiographic monitoring and exercise testing in patients with obstructive and nonobstructive hypertrophic cardiomyopathy. Circulation. 1979 May;59(5):866–875. doi: 10.1161/01.cir.59.5.866. [DOI] [PubMed] [Google Scholar]
  12. Shapiro L. M., McKenna W. J. Distribution of left ventricular hypertrophy in hypertrophic cardiomyopathy: a two-dimensional echocardiographic study. J Am Coll Cardiol. 1983 Sep;2(3):437–444. doi: 10.1016/s0735-1097(83)80269-1. [DOI] [PubMed] [Google Scholar]
  13. TEARE D. Asymmetrical hypertrophy of the heart in young adults. Br Heart J. 1958 Jan;20(1):1–8. doi: 10.1136/hrt.20.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Wheeler P. J., Puritz R., Ingram D. V., Chamberlain D. A. Amiodarone in the treatment of refractory supraventricular and ventricular arrhythmias. Postgrad Med J. 1979 Jan;55(639):1–9. doi: 10.1136/pgmj.55.639.1. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES