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Aims The outcome of alcoholic cardiomyopathy is thought to be better than idiopathic dilated cardiomyopathy if patients abstain from alcohol. The aim of this study was to compare the long-term clinical outcome of alcoholic and idiopathic dilated cardiomyopathy.Methods and Results Of 134 patients with dilated cardiomyopathy and normal coronary angiography, 50 had alcoholic cardiomyopathy; they were compared serially to 84 patients with idiopathic dilated cardiomyopathy. Left ventricular end-diastolic diameter, left ventricular ejection fraction and cardiac index, severity of ventricular arrhythmias, measurement of heart rate variability and results of signal-averaged ECG were similar in both groups. Although alcohol withdrawal was strongly recommended but observed in only 70% of patients with alcoholic cardiomyopathy, both groups had similar outcome in terms of cardiac death after follow-up treatment of 47±40 months. Multivariate analysis in the entire cohort demonstrated that increased pulmonary capillary wedge pressure (P=0·003), alcoholism and lack of abstinence during follow-up (P=0·006) and decreased standard deviation of all normal-to-normal RR intervals (P=0·02) were independent predictors of cardiac death.Conclusion In contrast with previous studies, patients with alcoholic cardiomyopathy did not have a better outcome than patients with idiopathic dilated cardiomyopathy. Alcoholism without abstinence was a strong predictor of cardiac death. This suggests that a more aggressive approach to alcohol cessation is needed in these patients. [ABSTRACT FROM PUBLISHER]

Eleven patients, with recurrent paroxysmal supraventricular tachycardias (PSVT) underwentprogrammed electrical stimulation of the heart to evaluate the efficacy of intravenous (i.v.) and oral tiapamil in these arrhythmias. The tachycardia circuit was confined to the atrio-ventricular (AV) node in 8 cases (group 1), and involved an overt or concealed accessory pathway for retrograde conduction in the 3 others (group 2). An i.v. bolus containing 2 mg kg body weight of tiapamil converted 6 of the 8 cases in group1 from PSVT to normal sinus rhythm (NSR) within a few seconds, but failed to do so in anyof the three patients in group 2. Both the oral and i.v. preparations significantly lengthened the shortest cycle length maintaining 1:1 AV conduction. i.v. administration also lengthened the corresponding value for 1:1 VA retrograde conduction. The oral and i.v. preparations were equally effective in preventing induction of PSVT in 6/8 patients in group 1, but failed in group 2. The efficacy of oral tiapamil in preventing such inductionwas also accurately predicted from the effect of the i.v. tiapamil on conversion to NSR. After the first week, the six successfully treated patients continued taking 1.2 to 1.5 gday tiapamil for 9.7 ± 4 months. Complete suppression of their symptoms was observed in 5 cases. [ABSTRACT FROM PUBLISHER]