Ventricular arrhythmias during ergonovine-induced episodes of variant angina

Jadwiga Szlachcic, David D. Waters, Douglas Miller, Pierre Théroux

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Of 95 consecutive patients with active variant angina who underwent ergonovine testing in the coronary care unit while off treatment, 24 (25%) developed serious ventricular arrhythmias: ventricular tachycardia in eight, bigeminy in seven, pairs in five, and frequent ventricular extrasystoles in four. Ergonovine-induced arrhythmias were observed more often in patients with anterior than inferior ST segment elevation (p < 0.05). ST segment elevation was significantly higher (10.3 ± 8.1 vs 3.1 ± 2.1 mm) in patients who developed arrhythmias. All ventricular arrhythmias began within 3 minutes after the onset of ST segment elevation. The intravenous administration of nitroglycerin eliminated arrhythmias in 22 of 24 cases; in only two patients did ventricular arrhythmias develop after the administration of nitroglycerin. Serious ventricular arrhythmias were found during spontaneous variant angina attacks in 14 of 24 patients with ergonovine-induced arrhythmias compared to 16 of 71 patients without ergonovine-induced arrhythmias (p < 0.001). We conclude that arrhythmias during ergonovine testing are most often caused by ischemia and not reperfusion. Patients with arrhythmias during ergonovine-induced attacks are more likely to have arrhythmias during spontaneous attacks.

Original languageEnglish (US)
Pages (from-to)20-24
Number of pages5
JournalAmerican Heart Journal
Volume107
Issue number1
DOIs
StatePublished - Jan 1984
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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