Multicenter survey on the validity of the CD-ROM guideline for antiarrhythmic drug therapy produced by the Japanese Circulation Society and the Japanese Society on Electrocardiology: preliminary report of the survey of the Japanese guideline for Arrhythmia Management By Individual Therapy (J-GAMBIT).

Abstract

BACKGROUND:

A multicenter investigational survey (Japanese Guideline for Arrhythmia Management By Individual Therapy) was conducted to evaluate the validity of using CD-ROM guidelines vs physician choice for the selection of antiarrhythmic drugs.

METHODS AND RESULTS:

Patients with paroxysmal atrial fibrillation (PAF, n=274) or premature ventricular contractions (PVC, n=216) were enrolled. The rate of concordance for drug selection between the treating physician and the CD-ROM was 216 of 274 patients (78.8%) with PAF. Of these, 168 (61.3%) were concordant for first-line agents and the remaining 48 (17.5%) were concordant for second-line agents. The concordance for the treatment of PVC was 154/216 cases (71.3%). Of these, 106 (49.1%) were concordant for first-line agents and the remaining 48 (22.2%) were concordant for second-line agents. Nonconcordance for PAF therapy was more likely to occur for patients with underlying heart disease (p<0.05), depressed cardiac function (p<0.001), and with more frequent ECG abnormalities and renal dysfunction. These differences were not seen in patients with PVC.

CONCLUSION:

The CD-ROM guidelines appear to be valid in the selection of antiarrhythmic drugs for both PAF and PVC, but their usefulness is influenced by the patient's clinical characteristics.

• Authors: Takao Katoh, Toshihiko Ohara, Satoshi Ogawa, Itsuo Kodama, committee members of the Guideline for Drug Treatment of Arrhythmias (JCS 2004)
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 69 Issue 11 Pg. 1357-60 (Nov 2005) ISSN: 1346-9843 [Print] Japan
• PMID: 16247211 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Anti-Arrhythmia Agents

Topics

• Aged
• Anti-Arrhythmia Agents (therapeutic use)
• Atrial Fibrillation (drug therapy)
• CD-ROM
• Data Collection
• Electrocardiography
• Female
• Guideline Adherence
• Humans
• Japan
• Male
• Middle Aged
• Practice Guidelines as Topic
• Societies, Medical
• Ventricular Premature Complexes (drug therapy)