Antiarrhythmic Effects of Tiapamil on Exercise-Induced Arrhythmias in Patients with Coronary Artery Disease

Abstract

57 patients were admitted to the study, 3-6 weeks after acute myocardial infarction. They received either placebo or 1 mg/kg tiapamil intravenously according to a randomized, double-blind procedure. The study had two objectives: (a) to assess the effect of tiapamil on work tolerance and exercise-induced myocardial ischemia; (b) to demonstrate possible antiarrhythmic effects against exercise-induced arrhythmias. The duration of exercise and physical work capacity increased slightly in both groups, these effects, however, not reaching statistical significance. On the other hand, the number of exercise-induced extrasystoles did not change significantly under placebo but decreased from 30.9 to 14.8 beats/min after tiapamil (p < 0.01). No side effects were observed. While the hemodynamic effects of tiapamil in patients with coronary artery disease are yet to be elucidated, our findings confirm the efficacy of this calcium antagonist against exercise-induced ventricular premature beats in patients with coronary artery disease.

Class IV Antiarrhythmic Agents: New Compounds Using an Old Strategy

“…In AMI patients, tiapamil effectively reduced the number of premature ventricular contractions [275], supraventricular extra beats [276] and HR to less than 90 beats/min, which latter effect was also seen in reoccurring tachyarrhythmias during successive tiapamil administrations [277]. 1 mg/kg intravenous tiapamil significantly reduced the number of exercise-induced extrasystoles in patients 3-6 weeks after AMI [278]. Tiapamil was effectively used in 32 surgical patients in the treatment of intra-and postoperative cardiac arrhythmias such as AF, supraventricular paroxysmal tachycardia and VEBs.…”

Structure and function of a dual antagonist of the human growth hormone and prolactin receptors with site-specific PEG conjugates

“…Importantly, the net amino acid modifications on pegvisomant prevents it from antagonizing the hGH-hPRLR binding ( 22 )—a critical factor for multiple reasons as follows. Anywhere from 15 to 40% of patients with acromegaly (a condition of GH excess due to a hypersecreting pituitary adenoma) also suffer from hyperprolactinemia due to elevated secretion of hPRL from the pituitary cells ( 54 , 55 , 56 ). These patients with acromegaly and hyperprolactinemia (adenomas secreting both hGH and hPRL) have significantly more severe menstrual disorders, galactorrhea, poorer surgical control, and higher adenoma relapse rates than GH-only pituitary adenoma patients ( 55 ).…”

Antiarrhythmic Effects of Tiapamil and Propranolol Assessed from the Reduction of Ventricular Arrhythmias in the Cycloergometer Test

“…An earlier study by our group [ 12] demon strated the efficacy o f tiapamil against effortinduced VEs in coronary patients. The antiarrhythmic effect o f propranolol is also well documented [12,13].…”

“…In this study, we administered tiapamil and propranolol at the same dosage levels as used by other investigators [1][2][3][4][5][6][7][12][13][14][15] which, considering their effect on SBP at peak exercise, can probably be considered equieffective. Our results confirmed the effi cacy o f both drugs against effort-induced VEs, their effects proving to be equivalent in terms of overall mean results in each group.…”