Serial testing of antiarrhythmic agents (group I and III or their combination) by means of programmed pacing using a simple protocol (1-3 premature stimuli during stimulation from the apex of the right ventricle at a rate of 100 [120] and 140/min) and milder criteria of the effectiveness of treatment (does not produce significant ventricular tachycardias of a frequency above 150/min and with a duration longer than 30 s) was performed in 21 patients with significant post-infarction ventricular tachycardia (same definition of significance). Effective treatment was found in serial testing in 17 patients, i.e. in 80%. According to the results of serial test and long-term adherence to treatment the patients were divided into two groups. Group I comprised 14 patients taking effective treatment up to the completion of the investigation and group II, seven patients, where effective treatment was not revealed during testing (4 patients) or was discontinued because of side-effects (3 patients). During long-term follow up (15.2 +/- 13.5 months) no significant ventricular tachycardias or sudden deaths were recorded in group I but in five patients of group II P less than 0.0003). A correct prediction of ventricular tachycardia or sudden death during long-term treatment was made in 19 patients, i.e. 90%. Serial testing of drugs by programmed stimulation is thus, when the above stimulation protocol is used in patients with significant ventricular tachycardia and with a myocardial infarction in the case-history, an effective method leading to a relatively low incidence of serious ventricular arrhythmic attacks.

Keywords: Aged; Anti-Arrhythmia Agents /therapeutic use/; Cardiac Pacing, Artificial; Female; Humans; Male; Middle Aged; Myocardial Infarction /complications/; Tachycardia /drug therapy/