Ventricular tachycardia during routine treadmill testing: risk and prognosis
Article Abstract:
Ventricular tachycardia (rapid, abnormal heart rhythms) during exercise usually causes great concern, suggesting serious heart disease with a very poor prognosis. More recently ventricular tachycardia during exercise testing in seemingly healthy people has been considered to be of no consequence. This study of 3,351 patients undergoing exercise testing attempted to determine the prevalence and the meaning of ventricular tachycardia. It was found that transient exercise-induced ventricular tachycardia during routine treadmill testing does not indicate an increased risk of heart attack or other events, either during testing or within two years afterward. Episodes of ventricular tachycardia were uncommon and usually were not repeated. Mortality among patients with tachycardia was 3.6 percent, compared with 5.1 percent in the total population. The prognosis was not worse even for those patients with coronary artery disease. The five patients with sustained ventricular tachycardia were treated, and no conclusions were drawn because of the small number. Nonsustained ventricular tachycardia is uncommon during treadmill testing, and the prognosis is a result of other factors, such as ventricular function, ischemia (reduced blood flow), and other symptoms. Treatment should be based on the other symptoms present, not on the episode of nonsustained ventricular tachycardia. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Internal Medicine
Subject: Health
ISSN: 0003-9926
Year: 1991
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Liver extract-folic acid-cyanocobalamin vs placebo for chronic fatigue syndrome
Article Abstract:
Chronic fatigue syndrome (CFS) has been of considerable interest to the public, and has been a point of controversy within orthodox medicine. Recently the Centers for Disease Control have proposed clinical criteria which allows some uniformity in diagnosing the condition. A group of patients who met these assessment criteria were asked to participate in an experiment to test the clinical value of an injection of beef liver extract, which is rich in folic acid, and cyanocobalamin - a regimen that has become a popular treatment for CFS in southern California. Fifteen patients were recruited and randomly assigned to receive either liver extract or a placebo. Patients were given instructions on administration of intramuscular injections of the medication and they received a one-week supply of pre-filled syringes. Patients in both groups reported increased vitality, but there was no measurable difference in response between the groups. Patients with CFS seem to have a strong response to a placebo and physicians who study or treat this condition should consider this finding before accepting claims for treatments that are not rigorously investigated.
Publication Name: Archives of Internal Medicine
Subject: Health
ISSN: 0003-9926
Year: 1989
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