Arrhythmology today: risks associated with anti-arrhythmic therapy in an internal medicine outpatient clinic

Czech version

Authors: J. Kautzner
Authors‘ workplace: Klinika kardiologie IKEM Praha, přednosta prof. MUDr. Josef Kautzner, CSc., FESC
Published in: Vnitř Lék 2011; 57(9): 702-708
Category: 65th birthday Mudr. Jany Laciné and and 60th birthday Milana Tržila

Overview

Arhytmology that is focused on diagnostics and therapy of heart rhythm disturbances and their complications has undergone dramatic development in last 2 decades. Widespread use of catheter ablation, introduction of implantable cardioverter-defibrillators for prevention of sudden cardiac death and finally, development of cardiac resynchronization therapy have lead to decreased importance of drug treatment. Antiarhythmic drugs remain therapy of choice in management of atrial fibrillation and in some ventricular arrhythmias, especially in patients with implantable cardioverter-defibrillator backup. Therefore, this review deals predominantly with a strategy of antiarythmic therapy in atrial fibrillation and discusses possible risks.

Key words:
arhythmology – antiarhythmic drugs – atrial fibrillation – long QT syndrome – proarhythmia

Sources

1. Kautzner J, Čihák R, Bytešník J. Pokroky v elektrofyziologii: katetrizační ablace srdečních arytmií a implantabilní kardiovertery-defibrilátory. Cor Vasa 2001; 43: 225–231.

2. Kautzner J. Radiofrekvenční katetrizační ablace: převrat v intervenční kardiologii. Prakt lékař 1999; 79: 274–282.

3. Kautzner J. Srdeční resynchronizační terapie v léčbě chronického srdečního selhání. Kardiofórum 2004; 1: 23–27.

4. Echt DS, Liebson PR, Mitchell LB et al. Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. N Engl J Med 1991; 324: 781–718.

5. Pratt CM, Camm AJ, Cooper W et al. Mortality in the Survival With ORal D-sotalol (SWORD) trial: why did patients die? Am J Cardiol 1998; 81: 869–876.

6. Hallstrom A, Friedman L, Denes P et al. AVID Investigators. Do arrhythmia patients improve survival by participating in randomized clinical trials? Observations from the Cardiac Arrhythmia Suppression Trial (CAST) and the Antiarrhythmics Versus Implantable Defibrillators Trial (AVID). Control Clin Trials 2003; 24: 341–352.

7. Camm AJ, Pratt CM, Schwartz PJ et al. AzimiLide post Infarct surVival Evaluation (ALIVE) Investigators. 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: 990–996.

8. Julian DG, Camm AJ, Frangin G et al. Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT. European Myocardial Infarct Amiodarone Trial Investigators. Lancet 1997; 349: 667–674.

9. Bardy GH, Lee KL, Mark DB et al. Amiodarone or an implantable cardioverter--defibrillator for congestive heart failure. N Engl J Med 2005; 352: 225–237.

10. Čihák R, Heinc P. Doporučení pro léčbu pacientů s fibriací síní. Cor Vasa 2004; 46: K 67–K77.

11. Camm AJ, Kirchhof P, Lip GY et al. European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Europace 2010; 12: 1360–1420.

12. Priori SG, Aliot E, Blomstrom-Lundqvist C et al. Task Force on Sudden Cardiac Death of the European Society of Cardiology. Eur Heart J 2001; 22: 1374–1450.

13. Gillis AM, Verma A, Talajic M et al. CCS Atrial Fibrillation Guidelines Committee. Canadian Cardiovascular Society Atrial Fibrillation Guidelines 2010: Rate and Rhythm Management. Can J Cardiol 2011; 27: 47–59.

14. Alboni P, Botto GL, Baldi N et al. Outpatient treatment of recent-onset atrial fibrillation with the ‘pill-in-the-pocket’ approach. N Engl J Med 2004; 351: 2384–2391.

15. Hohnloser SH, Kuck KH. Randomized trial of rhythm or rate control in atrial fibrillation: the Pharmacological Intervention in Atrial Fibrillation Trial (PIAF). Eur Heart J 2001; 22: 801–802.

16. Wyse DG, Waldo AL, DiMarco JP et al. Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Investigators. A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation. N Engl J Med 2002; 347: 1825–1833.

17. Roy D, Talajic M, Dorian P et al. Amiodarone to prevent recurrence of atrial fibrillation. Canadian Trial of Atrial Fibrillation Investigators. N Engl J Med 2000; 342: 913–920.

18. Van Gelder IC, Hagens VE, Bosker HA et al. Rate Control versus Electrical Cardioversion for Persistent Atrial Fibrillation Study Group. A comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation. N Engl J Med 2002; 347: 1834–1840.

19. Hagens VE, Van Veldhuisen DJ, Kamp O et al. RAte Control versus Electrical Cardioversion for Persistent Atrial Fibrillation Study Group. Effect of rate and rhythm control on left ventricular function and cardiac dimensions in patients with persistent atrial fibrillation: results from the RAte Control versus Electrical Cardioversion for Persistent Atrial Fibrillation (RACE) study. Heart Rhythm 2005; 2: 19–24.

20. Freudenberger RS, Wilson AC, Kostis JB. AFFIRM Investigators and Committees. Comparison of rate versus rhythm control for atrial fibrillation in patients with left ventricular dysfunction (from the AFFIRM Study). Am J Cardiol 2007; 100: 247–252.

21. Guglin M, Chen R, Curtis AB. Sinus rhythm is associated with fewer heart failure symptoms: insights from the AFFIRM trial. Heart Rhythm 2010; 7: 596–601.

22. Hohnloser SH, Crijns HJ, van Eickels M et al. ATHENA Investigators. Effect of dronedarone on cardiovascular events in atrial fibrillation. N Engl J Med 2009; 360: 668–678.

23. Davy JM, Herold M, Hoglund C et al. Dronedarone for the control of ventricular rate in permanent atrial fibrillation: the Efficacy and safety of dRonedArone for the cOntrol of ventricular rate during atrial fibrillation (ERATO) study. Am Heart J 2008; 156: 527.e1–527.e9.

24. Van Gelder IC, Groenveld HF, Crijns HJ et al. RACE II Investigators. Lenient vs strict rate control in patients with atrial fibrillation. N Engl J Med 2010; 362: 1363–1373.

25. Lafuente-Lafuente C, Mouly S, Longas--Tejero MA et al. Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. Cochrane Database Syst Rev 2007; 4: CD005–CD049.

26. McNamara RL, Bass EB, Miller MR et al. Management of new onset atrial fibrillation. Rockville (MD): Agency for Heathcare Research and Quality 2001.

27. Testa L, Biondi-Zoccai GG, Dello Russo A et al. Rate-control vs rhythm-control in patients with atrial fibrillation: a meta-analysis. Eur Heart J 2005; 26: 2000–2006.

28. Fux R, Greiner D, Geldmacher M et al. Multiple drug prescribing by general practitioners in a German region: Implications for drug interactions and patient safety. Int J Clin Pharmacol Ther 2006; 44: 539–547.

29. Humphries KH, Kerr CR, Steinbuch M et al. Canadian Registry of Atrial Fibrillation investigators. Limitations to antiarrhythmic drug use in patients with atrial fibrillation. CMAJ 2004; 171: 741–745.

30. Schutte D, Obel IWP. Dangerous and life-threatening drugs – practical lessons from the long QT syndrome. Cardiovasc J S Afr 2002; 13: 54–61.

31. Roden D. Taking the ‘idio’ out of ‘idiosyncratic’: Predicting torsade de pointes. Pacing Clin Electrophysiol 1998; 21: 1029–1034.

32. Jackman WM, Friday KJ, Anderson JL et al. The long QT syndromes: A critical review, new clinical observations and a unifying hypothesis. Prog Cardiovasc Dis 1988; 31: 115–172.

33. Vincent GM, Timothy KW, Leppert M et al. The spectrum of symptoms and QT intervals in carriers of the gene for the long QT syndrome. N Engl J Med 1992; 327: 846–852.

34. Priori SG, Napolitano C, Schwartz PJ et al. Low penetrance in the long-QT syndrome: clinical impact. Circulation 1999; 99: 529–533.

35. Roden DM, Anderson ME. The pause that refreshes, or does it? Mechanism of torsade de pointes. Heart 2000; 84: 235–237.

36. Antzelevitch C, Sicouri S. Clinical relevance of cardiac arrhythmias generated by after depolarizations: Role of M cells in the generation of U waves, triggered activity and torsade de pointes. J Am Coll Cardiol 1994; 23: 259–277.

37. Haverkamp W, Breithardt G, Camm AJ et al. The potential for QT prolongation and proarrhythmia by non-antiarrhythmic drugs: Clinical and regulatory implications. Report on a policy conference of the European Society of Cardiology. Eur Heart J 2000; 21: 1216–1231.

38. Canadian Adverse Drug Reaction Newsletter. Drugs causing prolongation of QT interval and torsade de pointes. Can Med Assoc J 1998; 158: 103–104.

39. Reilly JG, Ayis SA, Ferrier IN et al. QT--c-interval abnormalities and psychotropic drug therapy in psychiatric patients. Lancet 2000; 355: 1048–1052.

40. Rampe D, Murawsky MK, Grau J et al. The antipsychotic agent sertindole is a high affinity antagonist of human cardiac potassium channel HERG. J Pharmacol Exp Ther 1998; 286: 788–793.

41. Lherm T, Lottin F, Larbi D et al. Torsade de pointes after poisoning with fluoxetine alone. Presse Med 2000; 29: 306–307.

42. Liljeqvist JA, Edvardsson N. Torsade de pointes tachycardias induced by overdosage of zimeldine. J Cardiovasc Pharmacol 1989; 14: 666–670.

43. Mitchell JE, Mackenzie TB. Cardiac effects of lithium therapy in man. A review. J Clin Psychiatry 1982; 43: 47–51.

44. Antzelevitch C, Sun ZQ, Zhang ZQ et al. Cellular and ionic mechanisms underlying erythromycin-induced long QT intervals and torsade de pointes. J Am Coll Cardiol 1996; 28: 1836–1848.

45. Samaha FF. QTc interval prolongation and polymorphic ventricular tachycardia in association with levofloxacin. Am J Med 1999; 107: 528–529.

46. Zareba W, Moss AJ, Roscro S et al. Electrocardiographic findings in patients with diphenhydramine overdose. Am J Cardiol 1997; 80: 1168–1173.

47. Woosley RL, Chen Y, Freiman JP et al. Mechanism of the cardiotoxic actions of terfenadine. JAMA 1993; 269: 1532–1536.

48. Vorperian VR, Zhou Z, Mohammad S et al. Torsade de pointes with an antihistamine metabolite: potassium channel blockade with desmethylastemizole. J Am Coll Cardiol 1996; 28: 1556–1561.

49. Wysowski D, Bakanyi J. Cisapride and fatal arrhythmias. N Engl J Med 1996; 59: 383–388.

50. Hill SL, Evangelista JK, Pizzi AM et al. Proarrhythmia associated with cisapride in children. Pediatrics 1998; 101: 1053–1056.

51. Benton RE, Honig PK, Zamani K et al. Grapefruit juice alters terfenadine pharmacokinetics resulting in prolongation of repolarization on the electrocardiogram. Clin Pharmacol Ther 1996; 59: 383–388.

52. Michaëlsson M, Jonzon A, Riesenfeld T. Isolated congenital complete atrioventricular block in adult life: a prospective study. Circulation 1995; 92: 442–449.

53. Cooke RA, Chambers JB, Singh R et al. QT interval in anorexia nervosa. Br Heart J 1994; 72: 69–73.