The American journal of cardiology
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Comparative Study
Late (5 to 132 months) clinical and hemodynamic results after either tricuspid valve replacement or anuloplasty for Ebstein's anomaly of the tricuspid valve.
Late clinical and hemodynamic observations are described in 6 patients who had either tricuspid valve anuloplasty (TVA) (2 patients) or tricuspid valve replacement (TVR) (4 patients) 5 to 132 months earlier for Ebstein's anomaly of the tricuspid valve unassociated with right ventricular outflow obstruction. Of the 6 patients, 4 had improved postoperatively by 1 New York Heart Association functional class and 2 had improved by 2 functional classes. ⋯ Thus, the tricuspid valve operations in our 6 patients with Ebstein's anomaly were associated with a decrease in symptoms of cardiac dysfunction, a decrease in cardiac size, an increase in cardiac index and an increase in right ventricular and right atrial pressures. The elevation of the right atrial pressures postoperatively may have resulted from increased right ventricular filling pressures, persistent tricuspid regurgitation or bioprosthetic stenosis.
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Sudden cardiac death continues to be a major health hazard. Control of the problem requires identification of those at risk and effective therapy for prevention. Studies have shown that in patients with coronary disease or cardiomyopathy, salvos of ventricular tachycardia are an independent risk factor for sudden death. ⋯ This drug was continued long term in 15 patients. After 23 months of follow-up, only 1 patient died suddenly. Therefore, patients with life-threatening ventricular arrhythmia can be protected from a recurrence by individualized drug therapy.
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Comparative Study Clinical Trial
Lorcainide for high-frequency ventricular arrhythmia: preliminary results of a short-term double-blind and placebo-controlled crossover study and long-term follow-up.
Lorcainide, 100 mg twice daily was compared with placebo in 39 patients with frequent ventricular arrhythmias in a randomized double-blind crossover trial. A mean frequency of ventricular premature beats (VPBs) of at least 30 VPBs/hour was required during a drug-free period of 48 hours. Holter monitoring and a maximal symptom-limited exercise test were performed at the end of each of the 2-week double-blind treatment phase. ⋯ Lorcainide did not significantly reduce the exercise-related VPB frequency. At 6 months 61% of patients had significant VPB suppression. Thus, lorcainide was effective in reducing the frequency and grade of spontaneous ventricular arrhythmias during short- and long-term evaluation.