J Med Assoc Thai 2000; 83 (11):124

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Effect of Atenolol on Symptomatic Ventricular Arrhythmia Without Structural Heart Disease
Krittayaphong R Mail, Bhuripanyo K , Raungratanaampom O , Sriratanasathavorn C , Punlee K , Kangkagate C , Cheumsuk W , Chaithiraphan S

Ventricular arrhythmia (VA) from right ventricular outflow tract (RVOT) is a common
problem. Symptomatic patients are usually treated with beta-blockers. There is little data on the
systematic evaluation of the drug efficacy. The objectives of this study were I) To determine pro-
portion of exercise induced ventricular arrhythmia among patients with symptomatic ventricular
arrhythmia and 2) to determine the response to beta blockers and the correlation between the res-
ponse to betablockers and exercise induced VA.
We prospectively studied 46 consecutive patients with symptomatic ventricular arrhy-
thmia. Patients recorded their symptom scores underwent exercise testing and 24-hour ambulatory
monitoring before treatment and I month after atenolol. Exercise induced ventricular arrhythmia was
demonstrated in 28 per cent of patients with symptomatic ventricular arrhythmia. Atenolol improves
symptoms, decreases PVC count from ambulatory monitoring, increases exercise duration and
suppresses malignant form of VA during exercise. These effects are at a similar extent in both
groups of patients: those with and without exercise induced VA. However, the effect on ventricular
arrhythmia suppression during exercise of atenolol was seen only in patients with increased PVC
during exercise.
In conclusion, atenolol is a good option in treating patients with symptomatic VA from
RVOT regardless of the pattern of PVC response to exercise. Atenolol can suppress PVC during
exercise testing better in patients with exercise induced VA compared to those without.
Key word
: Atenolol, Ventricular arrhythmia

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