Effect of Atenolol on Symptomatic Ventricular Arrhyth- mia Without Structural Heart Disease

RUNGROJ KRITTAYAPHONG, M.D.*, ONGKARN RAUNGRATANAAMPORN, M.D.**, KESAREE PUNLEE, B.Sc. **, WANNA CHEUMSUK, B.Sc.**, KIERTUAI BHURIPANYO, M.D.**, CHARN SRIRATANASATHA VORN, M.D.**, CHARUWAN KANGKAGATE, M.S.**, SUPHACHAI CHAITHIRAPHAN, M.D., FACC*

Affiliation : * Division of Cardiology, ** Department of Medicine and Her Majesty Cardiac Center, Faculty of Medicine Siriraj Hospital, Mahidol Uni- versity, Bangkok 10700, Thailand.

AbstractVentricular arrhythmia (VA) from right ventricular outflow tract (RVOT) is a common problem. Symptomatic patients are usually treated with beta-blockers. There is little data on the systematic evaluation of the drug efficacy. The objectives of this study were I) To determine pro- portion of exercise induced ventricular arrhythmia among patients with symptomatic ventricular arrhythmia and 2) to determine the response to beta blockers and the correlation between the res- ponse to betablockers and exercise induced VA.
We prospectively studied 46 consecutive patients with symptomatic ventricular arrhy- thmia. Patients recorded their symptom scores underwent exercise testing and 24-hour ambulatory monitoring before treatment and I month after atenolol. Exercise induced ventricular arrhythmia was demonstrated in 28 per cent of patients with symptomatic ventricular arrhythmia. Atenolol improves symptoms, decreases PVC count from ambulatory monitoring, increases exercise duration and suppresses malignant form of VA during exercise. These effects are at a similar extent in both groups of
Patients : those with and without exercise induced VA. However, the effect on ventricular arrhythmia suppression during exercise of atenolol was seen only in patients with increased PVC during exercise.
In conclusion, atenolol is a good option in treating patients with symptomatic VA from RVOT regardless of the pattern of PVC response to exercise. Atenolol can suppress PVC during exercise testing better in patients with exercise induced VA compared to those without.

Keywords : Atenolol, Ventricular arrhythmia

All Articles Download

Information

Related Links