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Correlation of symptoms with occurrence of paroxysmal supraventricular tachycardia or atrial fibrillation: a transtelephonic monitoring study. The Flecainide Supraventricular Tachycardia Study Group.
- Source :
-
American heart journal [Am Heart J] 1992 Aug; Vol. 124 (2), pp. 381-6. - Publication Year :
- 1992
-
Abstract
- The purpose of this study was to determine whether symptoms recorded at the time of transtelephonic ECG monitoring (TTEM) correlate with attacks of paroxysmal supraventricular tachycardia (PSVT) or paroxysmal atrial fibrillation (PAF). We studied 113 patients with these arrhythmias who made a total of 3319 TTEM calls during their participation in double-blind, placebo-controlled, crossover, multicenter trials of flecainide therapy. Among 49 patients with PSVT, 62.7% of symptomatic calls were associated with ECG-documented PSVT as compared with 6.8% of asymptomatic calls (p less than 0.001). Similarly, among 69 patients with PAF, 69% of symptomatic calls were associated with ECG-documented PAF compared with 10.6% of asymptomatic calls (p less than 0.001). Both in patients with PSVT and PAF, an attack of PSVT or PAF could be documented by ECG in more than 70% of the calls when patients complained of tachycardia, increased sweating, or dyspnea. The sensitivity of a symptomatic call was 91% for PSVT and 89% for PAF, and it was not influenced by flecainide therapy. However, flecainide therapy was associated with a decrease in the positive predictive value of symptomatic TTEM calls and an increase in false positive TTEM transmissions. We conclude that in patients with symptomatic PSVT or PAF, there is a temporal relationship between symptoms and the occurrence of ECG-documented attacks of PSVT or PAF. However, sole reliance should not be placed on the presence or absence of symptoms as a measure of drug failure or efficacy, and it is important to document the cardiac rhythm by TTEM at the time symptoms are recorded.
- Subjects :
- Atrial Fibrillation drug therapy
Atrial Fibrillation epidemiology
Female
Flecainide therapeutic use
Humans
Male
Middle Aged
Predictive Value of Tests
Sensitivity and Specificity
Tachycardia, Paroxysmal drug therapy
Tachycardia, Paroxysmal epidemiology
Tachycardia, Supraventricular drug therapy
Tachycardia, Supraventricular epidemiology
Atrial Fibrillation diagnosis
Electrocardiography methods
Tachycardia, Paroxysmal diagnosis
Tachycardia, Supraventricular diagnosis
Telephone
Subjects
Details
- Language :
- English
- ISSN :
- 0002-8703
- Volume :
- 124
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- American heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 1636582
- Full Text :
- https://doi.org/10.1016/0002-8703(92)90601-q