Portal de Periódicos da CAPES

Ventricular arrhythmias during ergonovine-induced episodes of variant angina

1984; Elsevier BV; Volume: 107; Issue: 1 Linguagem: Inglês

10.1016/0002-8703(84)90127-3

1097-6744

Jadwiga Szlachcic, David D. Waters, D. Douglas Miller, Pierre Théroux,

Cardiac Arrhythmias and Treatments

Of 95 consecutive patients with active variant angina who underwent ergonovine testing in the coronary care unit while off treatment, 24 (25%) developed serious ventricular arrhythmias: ventricular tachycardia in eight, bigeminy in seven, pairs in five, and frequent ventricular extrasystoles in four. Ergonovine-induced arrhythmias were observed more often in patients with anterior than inferior ST segment elevation (p < 0.05). ST segment elevation was significantly higher (10.3 ± 8.1 vs 3.1 ± 2.1 mm) in patients who developed arrhythmias. All ventricular arrhythmias began within 3 minutes after the onset of ST segment elevation. The intravenous administration of nitroglycerin eliminated arrhythmias in 22 of 24 cases; in only two patients did ventricular arrhythmias develop after the administration of nitroglycerin. Serious ventricular arrhythmias were found during spontaneous variant angina attacks in 14 of 24 patients with ergonovine-induced arrhythmias compared to 16 of 71 patients without ergonovine-induced arrhythmias (p < 0.001). We conclude that arrhythmias during ergonovine testing are most often caused by ischemia and not reperfusion. Patients with arrhythmias during ergonovine-induced attacks are more likely to have arrhythmias during spontaneous attacks.