13th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 1998

January 24-31, 1998
Marilleva, Trento, Italy

RT-180

Holter sub-studies of the European Myocardial Infarct Amiodarone Trial

M. Malik, A.J. Camm, M.J. Janse*, D.G. Julian**, G.A. Frangin***, P.J. Schwartz° on behalf of the EMIAT Investigators.
Department of Cardiological Sciences, St. George's Hospital Medical School, London, UK, *Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, The Netherlands, **Netherhall Gardens, London, UK, ***Sanofi Recherche, Montpellier, France, °Department of Cardiology, University of Pavia and Policlinico S. Matteo IRCCS, Pavia, Italy

Abstract

Several retrospective analyses of subgroups of patients enrolled into the European Myocardial Infarct Amiodarone Trial (EMIAT) were performed in order to identify patients who might benefit from prophylactic amiodarone treatment and patients in whom amiodarone might be harmful. A part of these analyses involved baseline characteristics derived from baseline 24-hour Holter recordings that were available in the majority of patients enrolled into EMIAT. These characteristics included mainly increased mean 24-hour heart rate, presence of arrhythmia on Holter, and depressed 24-hour global heart rate variability. The sub-studies suggested that post-infarction patients who have not only reduced left ventricular ejection fraction but also specific markers of arrhythmia risk may benefit from prophylactic treatment with amiodarone. These studies might serve as a basis for future prospective trials where amiodarone could be tested in patients with a recent myocardial infarction, having a reduced left ventricular ejection fraction, a high initial heart rate and/or depressed heart rate variability.

Key Words

Major clinical trials
EMIAT trial, ECG Holter substudies, CAMIAT trial, CHF STAT trial, amiodarone, arrhytmia risk markers, postinfarction patients, reduced left ventricular ejection fraction, beta-blockers, high heart rate, R