benazepril and Tachycardia--Ventricular

Sixty patients, mean age 82 +/- 8 years, with congestive heart failure, prior myocardial infarction, normal left ventricular ejection fraction, and > or = 30 ventricular premature complexes per hour detected by 24-hour ambulatory electrocardiograms, and who were treated with diuretics, were randomized to treatment with benazepril 20 to 40 mg/day (30 patients) or to no benazepril (30 patients). At a median of 6 months after treatment, follow-up 24-hour ambulatory electrocardiograms showed that compared with no benazepril, benazepril caused no significant reduction in the number of ventricular premature complexes per hour or in the number of runs of ventricular tachycardia per 24 hours.

Topics: Aged; Aged, 80 and over; Angiotensin-Converting Enzyme Inhibitors; Benzazepines; Electrocardiography, Ambulatory; Female; Fourier Analysis; Heart Failure; Hemodynamics; Humans; Male; Myocardial Infarction; Prospective Studies; Signal Processing, Computer-Assisted; Stroke Volume; Tachycardia, Ventricular; Ventricular Function, Left

We studied 14 patients who had exercise-induced ventricular arrhythmias after a previous Q-wave myocardial infarction. All had symptomatic mild heart failure in New York Heart Association class II and a maximal oxygen consumption between 16 and 20 ml/kg/min. They were treated with the angiotensin converting enzyme inhibitor benazepril (20 mg) and hydrochlorothiazide (50 mg) for 3 months in a double-blind randomized cross-over study. Benazepril improved the maximal oxygen uptake by 15% and exercise time by 18%. Hydrochlorothiazide slightly increased exercise time (5%) and the respiratory exchange ratio but not oxygen consumption. The arrhythmias were nonsustained and reproducible in two baseline recordings. Compared with baseline, benazepril reduced the mean number (3.5 +/- 2.5) (+/- SD) of episodes of ventricular tachycardia by 66%, and total (47.4 +/- 40.9) and paired (5.2 +/- 4.5) premature ventricular contractions by 61% and 62%, respectively. Hydrochlorothiazide did not reduce the number of arrhythmias. Thus an improved cardiac function induced by benazepril is associated with a reduction in exercise-induced ventricular arrhythmias in patients with symptomatic mild heart failure after infarction.

Topics: Angiotensin-Converting Enzyme Inhibitors; Benzazepines; Cardiac Complexes, Premature; Double-Blind Method; Electrocardiography, Ambulatory; Exercise; Exercise Test; Heart Failure; Humans; Hydrochlorothiazide; Myocardial Infarction; Tachycardia, Ventricular

Electrical ventricular separation, as a special complete intraventricular block, denotes that ventricles be electrically separated into two or more parts caused by severe and wide damage of myocardium and conduction. Electrical ventricular separation can be divided into homologous and heterologous, homologous electrical ventricular separation is a rare phenomenon, literally the excitement of whole ventricle originate from supraventricle, on ECG, there are two different QRS waves which connect with an isoelectric line, one ST segment and T wave. We report a valve heart disease presented with complicated electrophysiological characteristics, which has reversed complex homologous electrical ventricular separation with second degree intraventricular block.

Topics: Acute Disease; Amiodarone; Angiotensin-Converting Enzyme Inhibitors; Anti-Arrhythmia Agents; Benzazepines; Diuretics; Electric Countershock; Electrocardiography; Furosemide; Heart Failure; Heart Valve Diseases; Heart Ventricles; Humans; Male; Metoprolol; Middle Aged; Pacemaker, Artificial; Spironolactone; Tachycardia, Ventricular

Topics: Animals; Anti-Arrhythmia Agents; Antihypertensive Agents; Benzazepines; Cardiomyopathies; Cardiotonic Agents; Dog Diseases; Dogs; Electrocardiography; Male; Pyridazines; Sotalol; Tachycardia, Ventricular; Ventricular Dysfunction, Right