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[Treatment of rhythm disorders by fenoxedil hydrochloride]
Insights
Fenoxedil chlorhydrate effectively restored sinus rhythm in most atrial fibrillation patients. However, careful patient selection and rigorous monitoring are crucial due to potential electrocardiographic side effects.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Fenoxedil chlorhydrate (FC) is indicated for cerebral circulatory failure and peripheral vascular disease.
- Cardiac arrhythmias require effective and safe treatment options.
Purpose of the Study:
- To evaluate the efficacy and safety of Fenoxedil chlorhydrate (FC) as an anti-arrhythmic agent in patients with various cardiac arrhythmias.
- To assess the impact of FC on electrocardiographic parameters and identify potential risks.
Main Methods:
- A study involving 100 patients with cardiac arrhythmias including atrial fibrillation, atrial flutter, atrial tachysystole, ventricular extrasystoles, and supraventricular extrasystoles.
- FC was administered alone or as an adjunct to anticoagulant or digitalis therapy, with specific contraindications noted.
- Electrocardiographic monitoring was performed to evaluate treatment outcomes and adverse effects.
Main Results:
- Sinus rhythm was restored in 74.4% of 78 atrial fibrillation cases.
- Positive responses were observed in atrial flutter and atrial tachycardia cases.
- Results for supraventricular and ventricular extrasystoles were less conclusive, requiring further investigation.
- Electrocardiographic changes, including QT interval lengthening and conduction disorders, were observed and sometimes exacerbated by FC.
Conclusions:
- Fenoxedil chlorhydrate demonstrates significant efficacy in treating certain cardiac arrhythmias, particularly atrial fibrillation.
- Its use necessitates thorough cardiac assessment prior to treatment and stringent clinical and electrocardiographic supervision to mitigate risks.
- Avoidance of concurrent use with specific medications and correction of potassium levels are critical safety measures.
Abstract:
Fenoxedil chlorhydrate (FC), which is used as a treatment for cerebral circulatory failure and peripheral vascular disease, has been given to 100 patients with a cardiac arrhythmia: atrial fibrillation (78 cases), atrial flutter (4 cases), atrial tachysystole (2 cases), ventricular extrasystoles (12 cases), and supraventricular extrasystoles (4 cases). FC has been prescribed alone, or as a complement to current anticoagulant or digitalis treatment; combination with prenylamine, amiodarone, dysopyramide or a drug of the quinidine group must always be avoided, and the potassium level checked and corrected if necessary before treatment. In 78 cases of atrial fibrillation, the authors found that sinus rhythm was restored in 58 (74.4%); four cases of flutter were restored, and one case out of two of atrial tachycardia. In case of supraventricular and ventricular extrasystoles the results are less clear, and merit a further study with a larger number of cases. The electrocardiographic disorders encountered in this series have been evaluated: lenghthening of the QT interval, disorders of atrioventricular conduction, sinus inhibition. They were either produced by or aggravated by the FC. No cases of axis deviation were encountered. The authors make mention of the complications observed by other authors, but draw a distinction between the prescription of FC in cases of cerebral vascular insufficiency, without previous knowledge of the exact cardiac status of the patient (otherwise there is a risk of severe accidents), and the use of FC in cases of arrhythmia which have undergone full assessment before the drug is used. According to this study, FC appears to be a very effective anti-arrhythmic agent, but its use demands very rigorous clinical and electrocardiographic supervision.