Aggravation of arrhythmia by antiarrhythmic drugs—Incidence and predictors

Podrid, Philip J.; Lampert, Steven; Graboys, Thomas B.; Blatt, Charles M.; Lown, Bernard

doi:10.1016/0002-9149(87)90200-1

Cited by 128 publications

(18 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Proarrhythmia, caused by class I and III agents, is manifested as a rise in ventricular ectopy, QT interval prolongation, torsades de pointes, monomorphic ventricular tachycardia, or excess bradycardia. Studies have shown that quinidine, flecainide, sotalol, and dofetilide are the antiarrhythmics most prone to ventricular proarrhythmia [12], Class I antiarrhythmic drugs are generally not recommended in the elderly. As observed in the CAST study [13], flecainide, among other Ic drugs, increased mortality in comparison to placebo, in patients who suffered from myocardial infraction.…”

Section: Rhythm-control In Atrial Fibrillationmentioning

confidence: 99%

Rhythm-control vs rate-control in the elderly: When to do it and which drug to prefer?

Botto¹,

Piemontese

Russo³

2018

Monaldi Arch Chest Dis

View full text Add to dashboard Cite

Atrial fibrillation (AF) is a relevant cardiovascular condition that is more prevalent in the elderly patients aged over 65 years. AF, with abnormal rate and rhythm can cause symptoms directly or indirectly by exacerbating other frequently coexisting cardiac conditions such as valvular heart disease, hypertension, ischemic cardiomyopathy, dilated cardiomyopathy, and hypertrophic cardiomyopathy. Evidence suggests that aging-related cardiovascular changes predispose the elderly to AF. Current therapeutic options such as antiarrhythmic drugs have not been extensively evaluated in the elderly population. Emerging pharmacological and non-pharmacological treatment options for the management of AF, such as dronedarone or catheter ablation, are of particular interest in the elderly. The present paper reviews the pathophysiology, diagnosis, and the management of AF in the elderly patient.

show abstract

Section: Rhythm-control In Atrial Fibrillationmentioning

confidence: 99%

Rhythm-control vs rate-control in the elderly: When to do it and which drug to prefer?

Botto¹,

Piemontese

Russo³

2018

Monaldi Arch Chest Dis

View full text Add to dashboard Cite

show abstract

“…The reported incidence of proarrhythmia with individual agents varies from 6% to 23% [1,7]. In addition, when serial drug testing with ambulatory monitoring was performed 34% of patients experienced arrhythmia aggravation with at least one agent.…”

Section: Noninvasive Evaluationmentioning

confidence: 99%

“…In the majority of cases the proarrhythmic event is a new sustained ventricular tachyarrhythmia [7,8]. Proarrhythmias also occur during exercise testing and may even be precipitated when ambulatory monitoring has demonstrated drug-induced arrhythmia suppression or when there is loss of inducibility with electrophysiologic testing.…”

Section: Noninvasive Evaluationmentioning

confidence: 99%

Proarrhythmia, a serious complication of antiarrhythmic drugs

Podrid

1999

Curr Cardiol Rep

Self Cite

View full text Add to dashboard Cite

Aggravation of arrhythmia with antiarrhythmic drugs is not an infrequent side effect associated with antiarrhythmic drugs. Defined as the provocation of a new arrhythmia or a significant increase in the frequency of a preexisting arrhythmia, it occurs with all antiarrhythmic agents, although the incidence varies from 6% to 23% with the different drugs. In general, arrhythmia aggravation is an early event, occurring within the first several days of initiating drugs therapy. It has been found, however, that this complication can also occur as a late event, particularly in patients who have evidence of ongoing ischemia that may be overt or silent. Although there is no good way to predict the patient who is likely to experience this complication, it has been observed that there several predictors of an increased risk for experiencing arrhythmia aggravation including significant underlying heart disease, congestive heart failure, evidence of active or potentially active ischemia, and electrolyte abnormalities, particularly hypokalemia.

show abstract

“…[71][72][73][74] In view of this concern about antidysrhythmic drug therapy, as well as the expense and inconvenience of life-long drug therapy, it is not surprising that considerable attention has been drawn to nonsurgical, nonpharmacological therapy for dysrhythmias.…”

Section: Antidysrhythmie Drugsmentioning

confidence: 99%