Abstract | BACKGROUND: AIM: To evaluate the short- and long-term efficacy and tolerance of AAD therapy and RFCA in patients with idiopathic PVCs. METHODS: This was a prospective, crossover, open-label study performed in 84 consecutive patients (mean age 47 ± 15 years; 60% women) with symptomatic idiopathic PVCs (mean PVCs/24 h, 13,768 ± 9,424; range 1,693-42,687). Patients were treated for 2-3 weeks with metoprolol, propafenone or verapamil. Then patients were referred for RFCA, if they had drug intolerance, inefficacy or did not wish to have prolonged AAD treatment. RESULTS: The most efficacious agent was propafenone, followed by verapamil, and then metoprolol [35 (42%), 13 (15%) and eight (10%) responders, respectively, p < 0.01 vs propafenone]. Only responders to drug treatment had a significant reduction in symptom severity (Visual Analogue Scale score: 6.2 ± 1.4 vs 2.7 ± 2.0, p < 0.001). After AAD, 50 (60%) patients underwent RFCA. During long-term follow-up (48 ± 10 months), RFCA (mean 1.2 procedures/patient) was effective in 44/50 (88%) patients. Of the 34 remaining patients, 21 remained on effective AAD, 6 patients remained on ineffective AAD, and 7 patients were taken off AADs therapy due to spontaneous remission of PVCs or a decrease in symptom severity. conclusions: Short-term treatment with propafenone was more effective than verapamil or metoprolol in suppressing idiopathic PVCs. However, optimal benefit was achieved with RFCA, which was effective and safe during long-term follow-up.
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Authors | Sebastian Stec, Agnieszka Sikorska, Beata Zaborska, Tomasz Kryński, Joanna Szymot, Piotr Kułakowski |
Journal | Kardiologia polska
(Kardiol Pol)
Vol. 70
Issue 4
Pg. 351-8
( 2012)
ISSN: 1897-4279 [Electronic] Poland |
PMID | 22528707
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Arrhythmia Agents
- Propafenone
- Verapamil
- Metoprolol
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Topics |
- Adolescent
- Adult
- Aged
- Analysis of Variance
- Anti-Arrhythmia Agents
(therapeutic use)
- Catheter Ablation
(methods)
- Cross-Over Studies
- Female
- Follow-Up Studies
- Humans
- Male
- Metoprolol
(therapeutic use)
- Middle Aged
- Propafenone
(therapeutic use)
- Prospective Studies
- Severity of Illness Index
- Time Factors
- Treatment Outcome
- Ventricular Premature Complexes
(therapy)
- Verapamil
(therapeutic use)
- Young Adult
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