PMID- 1395210
OWN - NLM
STAT- MEDLINE
DCOM- 19921030
LR  - 20131121
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 15 Suppl 1
DP  - 1992 Sep
TI  - Clinical significance and management of arrhythmias in the heart failure patient.
PG  - I13-21
AB  - Congestive heart failure (CHF) is a common manifestation of hypertension, 
      coronary artery disease, and dilated cardiomyopathy. The Framingham study showed 
      that the incidence of CHF increases twofold with each decade of age. The presence 
      of CHF increases the age-adjusted death rate 5.5-fold for women and 8-fold for 
      men, and it increases the sudden death rate 5.5-fold in both men and women. 
      Ventricular arrhythmias are a common accompaniment of CHF. Ambient ventricular 
      premature complexes occur in most of these patients, and nearly one half of all 
      CHF patients will have nonsustained ventricular tachycardia on a 24-h ambulatory 
      electrocardiographic (Holter) recording. In addition, low left ventricular 
      ejection fraction (LVEF) predicts inducible sustained ventricular tachycardia on 
      electrophysiologic study. One-year mortality increases with worsening New York 
      Heart Association (NYHA) Functional Class and decreasing LVEF. As the overall 
      yearly mortality increases, the proportion of patients who die of arrhythmias 
      decreases. The precise mechanism of death is frequently difficult to assess. 
      Nonarrhythmic causes of death include CHF, shock, electromechanical dissociation, 
      and myocardial rupture. Arrhythmic causes are most commonly due to ventricular 
      tachycardia/ventricular fibrillation. Bradycardic events (asystole or heart 
      block) are usually associated with progressively worsening CHF. Noncardiac causes 
      that may confuse classification include pulmonary embolus and cerebrovascular 
      accident. Because many patients have ischemic heart disease as the etiology of 
      the CHF, a recurrent ischemic event can likewise make classification difficult. 
      Overall, approximately one half of all deaths in CHF are arrhythmic and one half 
      are nonarrhythmic.
FAU - Greene, H L
AU  - Greene HL
AD  - Division of Cardiology, Harborview Medical Center, Seattle, Washington.
LA  - eng
GR  - R01 HL31472/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PT  - Review
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Anti-Arrhythmia Agents)
RN  - N3RQ532IUT (Amiodarone)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Amiodarone/therapeutic use
MH  - Anti-Arrhythmia Agents/*therapeutic use
MH  - Arrhythmias, Cardiac/drug therapy/*etiology/mortality
MH  - Cause of Death
MH  - Female
MH  - Heart Failure/*complications/epidemiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Randomized Controlled Trials as Topic
MH  - United States/epidemiology
RF  - 64
EDAT- 1992/09/01 00:00
MHDA- 1992/09/01 00:01
CRDT- 1992/09/01 00:00
PHST- 1992/09/01 00:00 [pubmed]
PHST- 1992/09/01 00:01 [medline]
PHST- 1992/09/01 00:00 [entrez]
PST - ppublish
SO  - Clin Cardiol. 1992 Sep;15 Suppl 1:I13-21.