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  • Title: [Value of provocation tests in the evaluation of the treatment of ventricular tachycardias with amiodarone].
    Author: Cassagneau B, Calazel J, Puel J, Massabuau P, Tournadre P, Fauvel JM, Bounhoure JP, Marin T, Narula OS.
    Journal: Arch Mal Coeur Vaiss; 1984 Jul; 77(7):766-72. PubMed ID: 6433839.
    Abstract:
    The role of provocation tests for the assessment of amiodarone therapy in patients with ventricular tachycardia remains a subject of controversy: recent studies seem to show that the ability to initiate VT in patients on amiodarone is compatible with a good long-term result. Eighteen patients, 16 male and 2 female, average age 56 years, were treated with amiodarone (600 mg/day in 15 cases, and 400 mg/day in 3 cases) and submitted to provocative tests before and after treatment. The mean follow-up period was 14 +/- 4 months. In Group I (5 patients), VT could not be initiated after treatment and there were no relapses of the arrhythmia. In Group II (6 patients), non-sustained VT could be initiated and only one relapse was observed after a close reduction from 600 to 400 mg/day; Group III comprised 5 patients with spontaneous recurrences. An identical VT could be initiated during electrophysiological investigation which served as a basis for selection of an effective antiarrhythmic association. Two patients could not be studied after drug impregnation (1 sudden death, 1 exacerbation of VT). The results of this study show that provocative pacing can be useful in evaluating the efficacy of amiodarone, as in Groups I and II (61% of patients) a favourable prognosis could be predicted in 91% of cases. In cases of therapeutic failure with spontaneous recurrences of VT, the same provocation tests enabled a more effective drug combination to be selected.
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