Comparative efficacy of sotalol and class I antiarrhythmic agents in patients with ventricular tachycardia or fibrillation: Results of the electrophysiology study versus electrocardiographic monitoring (ESVEM) trial

R. C. Klein, J. W. Mason, K. P. Anderson, J. L. Anderson, R. A. Freedman, D. A. Rawling, T. Moon, F. I. Marcus, L. Faileson, C. Pratt, C. R.C. Wyndham, A. Paciflco, C. R. Kerr, J. A. Yeung, J. C. Griffin, M. Scheinman, J. M. Herre, M. J. Reiter, D. Mann

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

The ESVEM Trial was a randomized prospective study to compare the predictive accuracy of electrophyslologic testing (EPS) to ambulatory electrocardiographic monitoring (Holter monitoring-HM) for long-term drug therapy of sustained ventricular tachyarrhythmias. 486 patients with documented ventricular tachycardia or resuscitated sudden death were randomized to EPS (n = 242) or HM (n = 244) and underwent serial drug testing with up to six antiarrhythmics; in the EPS limb a drug efficacy prediction was achieved in 108 patients (45%) comparted to 188 (77%) in the HM limb (P < 0.001). Efficacy predictions were most frequent with sotalol therapy. During long-term follow-up of the 296 patients discharged on a drug predicted to be effective there were 151 recurrrences of an arrhythmic event; there were no differences in actuarial rates of arrhythmia recurrence between EPS and HM. With multivariate testing of 14 variables only sotalol therapy and absence of prior antiarrhythmic therapy were associated with a significant reduction in risk of arrhythmia reccurrence.

Original languageEnglish
Pages (from-to)78-84
Number of pages7
JournalEuropean heart journal
Volume14
Issue numberSUPPL. H
StatePublished - Jan 1 1993
Externally publishedYes

Keywords

  • Antiarrhythmic therapy
  • Electrophysiologic testing vs ECG monitoring
  • Ventricular tachycardia

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    Klein, R. C., Mason, J. W., Anderson, K. P., Anderson, J. L., Freedman, R. A., Rawling, D. A., Moon, T., Marcus, F. I., Faileson, L., Pratt, C., Wyndham, C. R. C., Paciflco, A., Kerr, C. R., Yeung, J. A., Griffin, J. C., Scheinman, M., Herre, J. M., Reiter, M. J., & Mann, D. (1993). Comparative efficacy of sotalol and class I antiarrhythmic agents in patients with ventricular tachycardia or fibrillation: Results of the electrophysiology study versus electrocardiographic monitoring (ESVEM) trial. European heart journal, 14(SUPPL. H), 78-84.