Cardiac depression by intravenous disopyramide in patients with left ventricular dysfunction

Area of Science:

• Cardiology
• Clinical Pharmacology

Background:

• Left ventricular dysfunction poses significant challenges in cardiac care.
• Disopyramide phosphate is an antiarrhythmic drug with known hemodynamic effects.

Purpose of the Study:

• To evaluate the hemodynamic effects of intravenous disopyramide phosphate in patients with left ventricular dysfunction.
• To determine the safety and efficacy of disopyramide phosphate in this patient population.

Main Methods:

• Nine patients with left ventricular dysfunction received a disopyramide phosphate bolus (2 mg/kg over 5-15 minutes) followed by infusion.
• Hemodynamic parameters including systolic pressure, cardiac index, stroke index, right atrial pressure, and total peripheral resistance were monitored.
• Control measurements were taken before drug administration.

Main Results:

• Disopyramide phosphate administration led to significant decrements in systolic pressure, cardiac index, and stroke index.
• Increases in right atrial pressure and total peripheral resistance were observed.
• Two patients experienced profound hemodynamic deterioration requiring early termination; others showed partial recovery during infusion and recovery periods.

Conclusions:

• Intravenous disopyramide phosphate acts as a potent cardiac depressant in patients with left ventricular dysfunction.
• The drug should be used with extreme caution and only when conventional therapies are ineffective.
• Close patient monitoring is essential during disopyramide phosphate administration in this vulnerable group.