Efficiency of antiarrhythmic therapy and resistance to it in patients withmalignant ventricular tachyarrhythmias: Formulation of prognosis

Aim. To study feasibility of predicting results of drug antiarrhythmic ther apy in patients with malignant ventricular arrhythmias (MVA) basing on the results of clinical and device examinations. Materials and methods. 136 patients with documented MVA entered the study. 100 patients were in the retrospective analysis group, 36 patients comprise d the study group. All the patients underwent physical examination, resting EGG, chest x-ray, radionuclide ventriculography. Intracardiac electrophysi ological examination, Holter 24-h ECG monitoring and bicycle exercise provi ded data for diagnosis of MVA and control over effects of antiarrhythmic dr ugs. The mathematical model war; derived using discriminant analysis. Results. Significant differences were obtained in patients with positive an d negative results of drug testing by the number and recurrence time of ven tricular tachycardia (VT) for 3 years, survival, cardiac and sudden death, some other parameters. A mathematic model has been designed which allows pr ognosis of the results of antiarrhythmic therapy (AAT) in patients with MVA . 7 independent predictors of AAT efficiency are shown: left ventricular ej ection fraction, duration of P-Q interval, cardiac failure, left ventricula r aneurysm, age, number of VT morphologies, insufficiency of aortic valve. Verification of the model on the study group patients showed that prognosti c accuracy of the model was 82%. Conclusion. The results of the drug rests predict life span of MVA patients . The developed mathematical model allows prediction of AAT results in such patients before the pharmacological test with accuracy 82-87%. The model c an help objective indications to use of non-pharmacological methods for eac h patient basing on prognosis of resistance to drug AAT.