[Combinations of some anti-arrhythmia drugs]

The need to treat severe and repetitive arrhythmias which are often resistant to treatment with single different drugs has led to an increasing interest towards associations of antiarrhythmic drugs. The advantages of this associations could be: enhancing effect of different pharmacological properties, synergism, reduction of doses and side-effects. The risks are: induction or aggravation of excitability and conduction disturbances, impairment of contractility, hypotension, interaction with digoxin. This study describes our experience in using associations of antiarrhythmic drugs of different classes (IA + II, IA + III, IB + III) or of the same class (IA). We also report our preliminary results with the use of Propafenon-Amiodarone association in the acute treatment of electrophysiologically induced ventricular tachycardias and in the chronic treatment of repetitive and symptomatic ventricular tachycardias. Our experience demonstrates that the association of antiarrhythmic drugs is effective in the treatment of severe and repetitive arrhythmias only if the patients are carefully selected and the risks of unwelcome electrophysiological actions and side-effects are taken into account.