Effects of oral diltiazem on ventricular premature contractions

Ito, Morio; Maeda, Yasuhiro; Arita, Makoto; Ito, Sukenobu; Saikawa, Tetsunori; Omura, I; Fujino, Takehiko; Fukumoto, Tazuru; Kikuchi, Yutaka; Yamada, Kazuo; Yanaga, Takashi

doi:10.1016/s0022-0736(86)80008-5

Cited by 27 publications

(17 citation statements)

References 25 publications

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“…6 Thereafter, Ito et al clarified the particular relation between the PVCs frequency and HR as indirect evidence for delayed afterdepolarization leading to triggered arrhythmia. 7 They designated a positive correlation to cases showing more frequent PVCs at higher HR. Furthermore, they found such PVCs were sensitive to oral diltiazem or atenolol administered for 4 weeks or more.…”

Section: Pvcs Frequency and Heart Ratementioning

confidence: 99%

Heart Rate Variability Analysis of Patients With Idiopathic Left Ventricular Outflow Tract Tachycardia

et al. 1999

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Section: Pvcs Frequency and Heart Ratementioning

confidence: 99%

Heart Rate Variability Analysis of Patients With Idiopathic Left Ventricular Outflow Tract Tachycardia

et al. 1999

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“…The relationship between the PVC frequency and the heart rate was analyzed as reported previously. [10][11][12] In brief, the heart rate and PVC frequency per minute were calculated for each heart rate in 1 minute increments using the following formula: (number of PVCs in all minutes at a given heart rate)/(number of minutes at the given heart rate). Only the heart rates recorded for more than 5 minutes over 24 hours were used for the analyses.…”

Section: Methodsmentioning

confidence: 99%

“…Analysis using this system has been previously shown to be reliable. [10][11][12] The CI of PVCs was also calculated by measuring the CI of each PVC and averaged during each minute. The CI was then averaged every 10 HR increase from 50/min, namely from 50 to 110/min, and the slope between CI and HR was assessed.…”

Section: Methodsmentioning

confidence: 99%

“…This finding is in clear contrast with those of mexiletine and disopyramide, and reflects a possible beta-adrenergic blocking action of propafenone. Electrophysiological mechanism of PVCs and actions of propafenone: We previously reported 10,11) that atenolol (a class II antiarrhythmic drug) and diltiazem (a class IV antiarrhythmic drug) suppressed PVCs that show a positive correlation, but poor efficacy against those showing nonpositive PVC-HR correlations, i.e., PVC-HR correlations such as bidirectional. In vitro studies have shown that stim-Vol 42 No 6 ulation at higher heart rates increases the amplitude of delayed after-depolarization (DAD), leading to an increased probability of reaching the threshold for triggered activity.…”

Section: Comparison Of the Actions On P And Np Types Among Class I Agmentioning

confidence: 99%

“…10,11) This analysis is useful to characterize PVCs sensitive to the Ca antagonist diltiazem, and β-blockers such as atenolol and propranolol. Atenolol suppressed PVCs whose frequency increased with an HR increase, what we called a positive PVC-HR correlation.…”

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The Effect of Propafenone on Premature Ventricular Contractions (PVC). An Analysis Based on Heart Rate Dependency of PVCs.

Saikawa

Niwa

Ito³

et al. 2001

Jpn Heart J

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SUMMARYThe effect of 450 mg/day propafenone for two weeks on premature ventricular contractions (PVCs) was studied in combination with an assessment of heart rate (HR) dependency of PVCs using Holter ECG monitoring in patients with more than 720 PVCs per day. The PVC-HR correlation was classified into positive (P), bidirectional (B), and flat and negative (FN) correlation groups. The positive group included only patients in whom PVC frequency increased with a heart rate increase, while the bidirectional group included patients with PVCs whose frequency increased at low heart rates and decreased at high heart rates. The FN group contained both flat (PVC frequency was almost fixed regardless of heart rate changes) and negative (PVC frequency decreased as heart rate increased) correlations. The effectiveness of propafenone was 70% in the positive group and 50% in the nonpositive group which included both bidirectional (67%) and FN (0%) groups, using a > 70% PVC reduction as a criterion of efficacy. From this, we concluded that propafenone is effective in patients showing either positive or bidirectional PVC-HR correlation. The coupling interval (CI) of PVCs was also prolonged by propafenone as a whole. The present study suggests that there are differences in the mechanism of PVC development in patients with flat or negative correlation and those with a positive or bidirectional correlation. Thus, this type of analysis contributes to an understanding of the action of antiarrhythmic agents, and may allow the prediction of their efficacy on PVCs. (Jpn Heart J 2001; 42: 701-711)

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New analysis of the actions of antiarrhythmic drugs based on the heart rate dependency of ventricular premature contractions

Saikawa

Nakagawa

Takahashi

et al. 1992

Cardiovasc Drug Ther

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Key Words. Antiarrhythmie drugs, ventricular premature contractions, heart rate dependencyDear Sir,There have been numerous studies to assess the efficacy of antiarrhythmic drugs on ventricular premature contractions (VPCs) using a 24-hour ambulatory electrocardiogram (ECG) monitoring system. Most of the studies, however, focused simply on the reduction of either the frequency of VPCs or the severity of the arrhythmias, and the mechanisms underlying the arrhythmias or the modes of drug action have scarcely been concerned.It has been known that there is a distinct relation between the frequency of VPCs and the underlying heart rate. We previously analyzed the relation between VPC frequency and underlying heart rate and grouped this into four patterns [1]. These are (1) VPC frequency increases with increasing heart rates (positive correlation), (2) VPC frequency increases up to certain heart rate and decreases at much higher heart rates (bidirectional correlation), (3) VPC frequency stays constant over the entire range of heart rates (flat correlation), and (4) VPC frequency decreases as the heart rate increases (negative correlation).We analyzed the effects of class I, II, and IV antiarrhythmic drugs of Vaughan Williams classification on VPCs by Holter ECG recording [1][2][3]. Interestingly, diltiazem (a calcium antagonist) suppressed VPCs only when there was a positive correlation with heart rate, while atenolol (a beta blocker) was similar to diltiazem [2]. The detailed analysis of these results has lead us to hypothesize that the VPCs with positive VPC-HR correlation might derive from triggered activity following delayed afterdepolarization [1,2].In contrast, disopyramide and mexiletine (class I drugs) suppressed VPCs irrespective of their VPC-HR relation. Therefore, the analysis based on this VPC-HR correlation may be useful for the understanding and elucidation of ventricular arrhythmias.

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Effects of oral diltiazem on ventricular premature contractions

Cited by 27 publications

References 25 publications

Heart Rate Variability Analysis of Patients With Idiopathic Left Ventricular Outflow Tract Tachycardia

Heart Rate Variability Analysis of Patients With Idiopathic Left Ventricular Outflow Tract Tachycardia

The Effect of Propafenone on Premature Ventricular Contractions (PVC). An Analysis Based on Heart Rate Dependency of PVCs.

New analysis of the actions of antiarrhythmic drugs based on the heart rate dependency of ventricular premature contractions

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