Practical aspects and news in pharmacological treatment of arrhythmias
Authors:
P. Heinc
Published in:
Kardiol Rev Int Med 2005, 7(1): 10-16
Overview
In the field of arrhythmias it is possible to follow a continuous development of pharmacological treatment and above all non-pharmacological treatment. The review of treatment of bradycardias with essential indications for electrophysiological examination and radiofrequency ablation is given separately. Electrophysiological and clinical aspects of new antiarrhythmics are set forth. A practical review of diagnostics, general fundamentals of pharmacotherapy of arrhythmias and practical approaches of pharmacological treatment of supraventricular tachycardias and ventricular tachycardias is also given in this article.
Keywords:
bradyarrhythmia – tachyarrhythmia – diagnostics – electrophysiology – radiofrequency ablation – pharmacotherapy
news
Sources
1. DiMarco JP, Philbrick JT. Use of ambulatory electrocardiografic (Holter) monitoring. Ann Intern Med 1990; 113: 53–68.
2. Sovová E, Doupal V, Lukl J. Srovnání použití dvou přístrojů pro dlouhodobou monitoraci EKG při vyšetřování srdečních arytmií. Vnitř Lék 2001; 47(10): 670–673.
3. Gregoratos G, Cheitlin MD, Connil A et al. ACC/AHA guidelines for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the ACC/AHA Task Force on Practice Guidelines (Committee on Pacemakers Implantation). J Am Coll Cardiol 1998; 31: 1175–206.
4. Zásady pro implantaci kardiostimulátorů a implantabilních kardiovertrů – defibrilátorů. Cor Vasa 1997; 39(2; Suppl K): 35–42.
5. Zipes DP, DiMarco JP, Gillettte P et al. Guidelines for clinical intracardiac electrophysiologic studies and catheter ablation procedures. AHA/ACC Task Force report. Circulation 1995; 92: 673–91.
6. Moss AJ, Hall WJ, Cannon DS et al. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmias. N Engl J Med 1996; 335(26): 1933–1940.
7. Buxton AE, Lee KL, Fisher JD et al. A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. N Engl J Med 1999; 341(25): 1882–1890.
8. Kautzner J. Léčba a prevence náhlé srdeční smrti – reálný cíl? JAMA–CS 1999; 7: 820–821.
9. Heinc P. Role katetrové ablace u supraventrikulárních tachyarytmií. In: Lukl V, Heinc P et al. Moderní léčba arytmií. Praha: Grada 2001: 119–135.
10. Hindricks G. The Multicenter European Radiofreguency Survey (MERFS): complicatons of radiofrequency ablation of arrhythmias. Eur Heart J 1993; 14: 1644–1653.
11. Calkins H, Yong P, Miller JM et al. Catheter ablation of accessory pathways, atrioventricular nodal reentry tachycardia, and the atrioventricular junction: final results of a prospective, multicenter clinical trial. Circulation 1999; 99(2): 262–270.
12. Capatto R, Kuck KH. Catheter ablation in the year 2000. Curr Opin Cardiol 2000; 15: 29–40.
13. Morady F. Radio–frequency ablation as treatment for cardiac arrhythmias. N Engl J Med 1999; 340: 534–544.
14. Anderson J. Acute treatment of atrial fibrillation and flutter. J Am Coll Cardiol 1996; 17: 17–21.
15. Waldo A, Prystowsky EN. Drug treatment of atrial fibrillation in the managed era. Am J Cardiol 1998, 81(5; Suppl C): 23–29.
16. Podrid PJ. Amiodarone: Reevaluation of an old drug. Ann Int Med 1995; 122(9): 689–700.
17. The Sicilian Gambit. A new approach to the classification of antiarrhythmic drugs based on their actions on arrhythmogenic mechanisms. Eur Heart J 1991; 12(10): 1112–1131.
18. Hondeghem LM, Snyders DJ. Class III antiarrhythmic agents have a lot of potential but a long way to go. Circulation 1990; 81: 686–690.
19. Antzelevith C, Sicouri S. Clinical relevance of cardiac arrhythmias generated by afterdepolarizations. J Am Coll Cardiol 1994; 23(1): 259–277.
20. Jurkiewicz NK, Sanguinetti MC. Rate–dependent prolongation of cardiac action potentials by a methanesulfonanilide class III antiarrhythmic agent: Specific block of rapidly activating delayed rectifier K current by dofetilide. Circ Res 1993; 72(1): 75–83.
21. Wang Z, Fermini B, Nattel S. Delayed rectifier outward current and repolarization in human atrial myocytes. Circ Res 1993; 73(2): 276–285.
22. Woosley RL, Hardey JT, Wang T et al. Concentration response relations for the multiple antiarrhythmic actions of sotalol. Am J Cardiol 1990; 65(2; Suppl A): 22–27.
23. Anastasiou–Nana MI, Gilbert EM, Miller RH et al. Usefulness of DL sotalol for suppression of chronic ventricular arrhythmias. Am J Cardiol 1991; 67: 511–516.
24. Thumala A, Harnmermeister KE, Campbell WB et al. Hemodynamic studies with sotalol in men performed at rest, during exercise and during right ventricular pacing. Am Heart J 1971; 82(4): 439–447.
25. Lloyd EA, Charles RG, Gordon–GD et al. Beta–blockade by sotalol in early myocardial infarction decreases ventricular arrhythmias without increasing left ventricular volume. S Afr Med J 1988; 74(1): 5–10.
26. Winters SL, Kukin M, Pe E et al. Effect of oral sotalol on systemic hemodynamics and programmed electrical stimulation in patients with ventricular arrhythmias and structural heart disease. Am J Cardiol 1993; 72(4; Suppl A): 38–43.
27. Sung RJ, Tan HL, Karagounis L et a1. Intravenous sotalol for the termination of supraventricular tachycardia and atrial fibrillation and flutter. A multicenter, randomized, double–blind, placebo controlled study. Sotalol Multicenter Studv Group. Am Heart J 1995; 129(4): 739–748.
28. Vos MA, Golitsin SR, Stangl K et al. Superiority of ibutilide (a new class III agent) over DL–sotalol in converting atrial flutter and fibrillation. Heart 1998; 79(6): 568–573.
29. Poelzl G, Kratzer H, Ebner A et al. Prospective comparison of flecainide versus sotalol for immediate cardioversion of atrial fibrillation. Am J Cardiol 1998; 81(12): 1450–1454.
30. Benditt DG, Williams JH, Jin J et al. Maintenance of sinus rhythm with oral DL sotalol therapy in patients with symptomatic atrial fibrillation and/or atrial flutter. Am J Cardiol 1999; 84: 270–277.
31. Reimold SC, Cantillon CO, Friedman PL et al. Propafenone versus sotalol for suppression of recurrent symptomatic atrial fibrillation. Am J Cardiol 1993; 71(7): 558–563.
32. Lee SH, Chen S.A, Tai DT et al. Comparison of oral propafenone and sotalol as an initial treatment in patients with symptomatic paroxysmal atrial fibrillation. Am J Cardiol 1997; 79: 905–908.
33. Carunchio A, Fera MS, Mazza A et al. A comparison between flecainide and sotalol in the prevention of recurrences of paroxysmal atrial fibrillation. G Ital Cardiol 1995; 25(1): 51–68.
34. Roy D, Talajic M, Dorian P et al. Amiodarone to prevent recurrence of atrial fibrillation. N Engl J Med 2000; 343(13): 913–920.
35. Rasmussen HS. Dofetilide, a novel class 3 antiarrhythmic agent. J Cardiovasc Pharmacol 1992; 20: 96–104.
36. Tham TCK, Mac Lennan BA, Burke M et al. Pharmacodynamics and pharmacokinetics of the class III antiarrhythmic agent dofetilide in humans. J Cardiovasc Pharmacol 1993; 21: 507–512.
37. Demolis GM, Funck–Brentano C, Ropers JR et al. Influence of dofetilide on QT interval duration and dispersion at various heart rates during exercise in humans. Circulation 1996; 94(7): 1592–1599.
38. Kowey PR, Marinchack RA, Rials SJ et al. Pharmacologic and pharmacokinetic profile of the class 3 antiarrhythmic drugs. Am J Cardiol 1997; 80(Suppl G): 16–23.
39. Nademanee K, Bailey WM, O'Neill G et al. Electrophysiologic and hemodynamic effects of dofetilide in patients with depressed ventricular function: A randomized, double–blind, placebo–controlled study. PACE 1998; 21: 867.
40. Singh SN, Zab1 RG, Yellen LG et al. Efficacy and safety of oral dofetilide in converting to and maintaining sinus rhythm in patients with chronic atrial fibrillation or atrial flutter. The symptomatic atrial fibrillation investigative research on dofetilide (SAFIRE–D) study. Circulation 2000; 102: 2385–2390.
41. Campbell T, Greenbaum RA, Channer KS et al. Mortality in patients with atrial fibrillation –1 year follow up of EMERALD (European and Australian Multicenter Evaluation Research of Atrial Fibrillation Dofetilide). J Am Coll Cardiol 2000; 35(Suppl A): 154.
42. Norgaard BL, Watchell K, Christensen PD et al. Efficacy and safety of intravenously administered dofetilide in acute termination of atrial fibrillation and flutter: A multicenter, randomized, double–blind, placebo–controlled trial. Am Heart J 1999; 137(6): 1062–1069.
43. Pedersen OD, Bagger H, Keller N et al. Efficacy of dofetilide in the treatment of atrial fibrillation–flutter in patients with reduced left ventricular functions. A Danish Investigations of Arrhythmia and Mortality ON Dofetilide (DIAMOND) substudy. Circulation 2001; 104(3): 292–295.
44. Pratt CM, Ruskin JN, Friedrieck T. Dofetilide use in atrial fibrillation: A treatment strategy to minimize proarrhythmic risk. (Abstract). J Am Coll Cardiol 2000; 35(Suppl A): 154.
45. Lee KS. Ibutilide, a new compound with potent class 3 antiarrhythmic activity, activates a slow inward Na+ current in guinea pig ventricular cells. J Pharmacol Exp Ther 1998; 262(1): 99–108.
46. Yang T, Snyders DJ, Roden DM. Ibutilide, a methanesulfonanilide antiarrhythmic, is a potent blocker of the rapidly–activating delayed rectifier K current (I,U) in AT–1 cells. Circulation 1995; 91: 216–221.
47. Murray KT. Ibutilide. Circulation 1998; 97: 493–497.
48. Volgman AS, Carberry PA, Stambler BS. Conversion efficacy and safety of intravenous ibutilide compared with intravenous procainamide in patients with atrial flutter or fibrillation. J Am Coll Cardiol 1998; 31: 1414–1419.
49. Tai ChT, Chen SA, Feng AN et al. Electropharmacologic effect of class I and class III antiarrhythmia drugs on typical atrial flutter. Circulation 1998; 97: 1935–1945.
50. Oral K, Souza JJ, Michaud GF et al. Facilitating transthoracic cardioversion of atrial fibrillation with ibutilide pretreatment. N Engl J Med 1999; 340(24): 1849–1854.
51. Kowey PR, VanderLugt JR, Luderer JR. Safety and risk/benefit analysis of ibutilide for acute cardioversion of atrial fibrillation/flutter. Am J Cardiol 1996; 78(8; Suppl A): 46–52.
52. Pritchett E, Page R. Connoly S et al. Antiarrhythmic effects of azimilide in atrial fibrillation: Efficacy and dose–response. Azimilide Supraventricular Arrhythmia Program (SVA–)3 Investigators. J Am Coll Cardiol 2000; 36(3): 794–802.
53. Camm AJ, Pratt CM, Schwartz PJ et al. Mortality in patients after a recent myocardial infarction. A randomized, placebo–controlled trial of azimilide using heart rate variability for risk stratification. Circulation 2004; 109(8): 990–996.
54. Manning AS, Bruyninckx C, Ramboux J et al. SR 33589, a new amiodarone–like agent: Effect on ischemia and reperfusion–induced arrhythmias in anesthesized rats. J Cardiovasc Pharmacol 1995; 26: 453–461.
55. Sun W, Sarma JSM, Singh BN. Electrophysiological effects of dronedarone (SR33589), a non–iodinated benzofuran derivative, in the rabbit heart. Circulation 1999; 100: 2276–2281. doplnit svazek
56. Verdvin SC, Vos MA, Leunissen HDM et al. Evaluation of the acute electrophysiologic effect of intravenous dronedarone, an amiodaron–like agent, with special emphasis on ventricular repolarization and acquired torsade de pointes arrhythmias. J. Cardiovasc Pharmacol 1999; 33: 212–222.
57. Wang Z, Fermini B, Nattel S. Sustained depolarization–induced outward current in human atrial myocytes: Evidence for a novel delayed rectifier K current in human ventricle. Circ Res 1993; 73: 1061–1076.
58. Sato R, Hisatome I, Wasserstrome JA. Acetylcholine sensitive potassium channels in human atrial myocytes. Am J Physiol 1990; 259(6; Suppl H):1730–1735.
59. Farshi R, Kistner D, Sarma JS et al. Ventricular rate control in chronic atrial fibrillation during daily activity and programmed exercise. J Am Coll Cardiol 1999; 33(2): 304–310.
60. Lewis R, Lakhami M, Moreland TA et al. A comparison of verapamil and digoxin in the treatment of atrial fibrillation. Eur Heart J 1987; 8(2): 148–51.
61. Rawles JM. What is meant by a „controlled“ ventricular rate in atrial fibrillation? Br Heart J 1990; 63: 157–61.
62. Gomes JA, Hariman RI, Kang PS et al. Sustained symptomatic sinus node reentrant tachycardia: Incidence, clinical significance, electrophysiologic observations and the effects of anti–arrhythmic agents. J Am Coll Cardiol 1985; 5: 545–557.
63. The Cardiac Arrhythmia Supression Trial (CAST) investigators. Preliminary report: Effect of encainide anf flecainide on mortality in randomized trial of arrhythmia supression after myocardial infarction. N Engl J Med 1989; 3321: 406–412.
64. Waldo AL, Camm AJ, deRuyter H et al. Effect of d–sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. Lancet 1996; 348: 7–11.
65. Flaker GC, Blackshear JL, McBride R et al. Antiarrhythmic drug therapy and cardiac mortality in atrial fibrillation. J Am Coll Cardiol 1992; 20: 527–532.
66. Middlekauff HR, Stevenson WG, Saxon LA et al. Amiodarone and torsades de pointes in patients with advanced heart failure. Am J Cardiol 1995; 76(7): 499–502.
67. MacNeil DJ. The side effect profile of class III antiarrhythmic drugs; focus on d, l–sotalol. Am J Cardiol 1997; 80(Suppl G): 90–8.
68. Predictors of thromboembolism in atrial fibrillation: II. Echocardiographic features of patients at risk. The Stroke Prevention in Atrial Fibrillation Investigators. Ann Intern Med 1992; 116(1): 6–12.
69. Kjekshus J. Arrhythmias and mortality in congestive heart failure. Am J Cardiol 1990; 65(Suppl I): 42–48.
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Paediatric cardiology Internal medicine Cardiac surgery CardiologyArticle was published in
Cardiology Review
2005 Issue 1
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