Morganroth J, Bigger J T, Anderson J L
Center of Excellence for Cardiovascular Studies of the Graduate Health System, Graduate Hospital, Philadelphia, Pennsylvania 19146.
Am J Cardiol. 1990 Jan 1;65(1):40-8. doi: 10.1016/0002-9149(90)90023-t.
To define the practice habits of United States cardiologists and the treatment of ventricular arrhythmias, a random sample of 1,000 of 12,000 cardiologists was sent a pretested questionnaire. After follow-up procedures, 252 responded, of which 18% were academically-based, 29% were hospital-based and 53% were office-based. Attitudes about antiarrhythmic drug therapy for the treatment of ventricular arrhythmias were influenced by the presence and severity of cardiac disease, the presence and severity of cardiac disease, the presence of symptoms and the type of ventricular arrhythmias. In this survey, only 1% of cardiologists treated patients with asymptomatic ventricular premature complexes and no heart disease, but 17% treated such patients if unsustained ventricular tachycardia was present. The treatment rate among cardiologists increased to 38% when coronary artery disease with left ventricular dysfunction was present in patients with asymptomatic ventricular premature complexes. The presence of any cardiac disease and symptomatic ventricular arrhythmias increased the treatment rate to 80 to 100%. Approximately 50% of responding physicians treated patients comparable to the Cardiac Arrhythmia Suppression Trial study population with antiarrhythmic drugs. Beta blockers were the most common antiarrhythmic drug class chosen as the most appropriate initial therapy in new patients with ventricular arrhythmias. Whereas no cardiologists thought that amiodarone was appropriate to initiate in new patients with benign or potentially malignant ventricular arrhythmias, as many as 33 to 43% of cardiologists would use amiodarone for refractory patients with such arrhythmias, a response contradictory to the approved labeling for this drug. Less than one half of cardiologists recognize the high potential organ toxicity for quinidine, procainamide and tocainide.(ABSTRACT TRUNCATED AT 250 WORDS)
为明确美国心脏病专家的执业习惯及室性心律失常的治疗情况，从12000名心脏病专家中随机抽取1000名，向其发送一份经过预测试的问卷。经过后续程序，252人做出回应，其中18%以学术机构为基础，29%以医院为基础，53%以诊所为基础。对于室性心律失常抗心律失常药物治疗的态度受心脏病的存在及严重程度、症状的存在以及室性心律失常的类型影响。在本次调查中，只有1%的心脏病专家治疗无症状室性早搏且无心脏病的患者，但如果存在非持续性室性心动过速，17%的专家会治疗此类患者。对于无症状室性早搏且伴有左心室功能不全的冠心病患者，心脏病专家的治疗率增至38%。任何心脏病和有症状的室性心律失常的存在使治疗率提高到80%至100%。约50%的回应医生用抗心律失常药物治疗与心律失常抑制试验研究人群类似的患者。β受体阻滞剂是新患室性心律失常患者最常被选为最适当初始治疗的抗心律失常药物类别。虽然没有心脏病专家认为胺碘酮适合用于新患良性或潜在恶性室性心律失常的患者，但多达33%至43%的心脏病专家会将胺碘酮用于此类心律失常的难治性患者，这一反应与该药物的批准标签相悖。不到一半的心脏病专家认识到奎尼丁、普鲁卡因胺和妥卡尼具有高潜在器官毒性。（摘要截选至250词）
