[Electrophysiological evaluation of the treatment of patients with recurrent ventricular tachycardia].

In order to asses the predictive value of serial electrophysiologic studies in the selection of an effective long-term effective antiarrhythmic regimen, we studied 16 patients with recurrent sustained ventricular tachycardia (VT), resistant to conventional medical treatment. (group 1) Eleven patients in this group had chronic chagas myocarditis, and several hospitalizations and cardioversions had been required for therapy of VT. In addition, 35 patients (group 2: control) underwent electrophysiological studies to evaluate rhythm disturbances differences to TV. Ventricular Tachycardia was successfully initiated and terminate with programmed electrical stimulation of the right ventricle only in the group 1. After control studies, the effects of several drugs (ajmalin, amiodarone, carbamazepine, disopyramide, diphenilhydantoin, mexiletine, procainamide, propranolol, quinidine and verapamil on the ability to initiate VT were assessed. A drug was considered effective only if it prevented the initiation of VT and allowed long-term suppression o clinical VT. All the patients of group 1 were placed on chronic oral therapy with the effective agent and were followed for an average period of 16 months (range 5 to 47 months). In all 16 patients we could document complete long-term prophylaxis against VT. This method offers advantage in terms of morbidity, mortality, duration of therapy, and promptness of choosing an effective drug add expense to the patient over traditional empirical methods of drug selection.