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Related Experiment Videos

Acute oral antiarrhythmic testing with disopyramide

D García-Barreto, A Toruncha, A Gonzalez-Gomez

    Clinical Cardiology
    |November 1, 1981
    PubMed
    Summary

    Disopyramide effectively reduced frequent ventricular premature depolarizations (VPD) in most patients. However, some experienced relapses or side effects like heart failure, indicating personalized treatment is crucial.

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    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Ventricular premature depolarization (VPD) is a common arrhythmia.
    • Assessing antiarrhythmic drug efficacy requires objective measures of cardiac function.

    Purpose of the Study:

    • To evaluate the acute efficacy and cardiac effects of disopyramide in patients with frequent VPD.
    • To assess left ventricular performance using systolic time intervals (STI).

    Main Methods:

    • Acute antiarrhythmic drug testing with oral disopyramide (300 mg loading dose) in 25 patients with frequent VPD.
    • Monitoring of VPD frequency and grade, onset of action, and plasma drug levels.
    • Assessment of left ventricular performance via systolic time intervals (STI), including pre-ejection period (PEP) and PEP/ejection time ratio.
    • Single-blind placebo challenge in responding patients.

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    Main Results:

    • Eighteen of 25 patients (72%) showed significant reduction (≥80%) in VPD and abolition of advanced grades.
    • Mean onset of action was 93 minutes, with a mean plasma level of 3.4 µg/mL at 2 hours.
    • STI revealed increased PEP and PEP/ejection time ratio at peak disopyramide concentrations.
    • Placebo challenge did not significantly alter VPD frequency or grade in responders.
    • Side effects included anticholinergic effects; 3 patients discontinued disopyramide due to aggravated heart failure.

    Conclusions:

    • Disopyramide demonstrates acute efficacy in reducing frequent ventricular premature depolarizations (VPD).
    • Systolic time intervals (STI) can monitor disopyramide's impact on left ventricular performance.
    • Potential for relapse and adverse effects like heart failure necessitate careful patient selection and monitoring.