Critical review of the approaches to the prevention of sudden death

Yusuf, Salim; Venkatesh, G; Teo, Koon K.

doi:10.1016/0002-9149(93)90963-d

Cited by 19 publications

(8 citation statements)

References 34 publications

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“…However, the results of trials of antiarrhythmic drugs have mostly been adverse: 4,5,19,20 antiarrhythmic drug therapy was associated with increased deaths, in most cases sudden and presumably arrhythmic, that were attributed to a proarrhythmic effect. Yusuf and colleagues' meta-analysis 21 of trials of antiarrhythmic drugs after myocardial infarction showed that sodium-channel blockers were harmful and that calcium-channel antagonists had no beneficial effects; by contrast, a favourable effect was observed with the use of amiodarone in a small population. Similarly, Teo and colleagues' meta-analysis 22 of placebo-controlled trials of amiodarone after myocardial infarction or in patients with heart failure suggested that survival substantially improved with the use of amiodarone.…”

Section: Discussionmentioning

confidence: 99%

Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT

Julian¹,

et al. 1997

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Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT Julian, D.G.; Camm, A.J.; Frangin, G.; Janse, M.J.; Munoz, A.; Schwartz, P.J.; Simon, P. General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Download date: 22 Mar 2019Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT D G Julian, A J Camm, G Frangin, M J Janse, A Munoz, P J Schwartz, P Simon, for the European Myocardial Infarct Amiodarone Trial Investigators* THE LANCET SummaryBackground Ventricular arrhythmias are a major cause of death after myocardial infarction, especially in patients w it h poor left -vent ric ular func t ion. P revious at t empt s t o ident ify and suppress arrhy t hmias w it h v arious antiarrhythmic drugs failed to reduce or actually increase mortality. Amiodarone is a powerful antiarrhythmic drug with several potentially beneficial actions, and has shown benefit in several small-scale studies. We postulated that this drug might reduce mortality in patients at high risk of death after myocardial infarction because of impaired vent ric ular func t ion, irrespective of w hether they had ventricular arrhythmias.

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Section: Discussionmentioning

confidence: 99%

Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT

Julian¹,

et al. 1997

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“…SCD occurs in approximately 75,000-100,000 people annually in the UK and represents the largest proportion of the deaths attributable to coronary heart disease 4,5 (Table 1). Approximately 85-90% of SCD is due to a first arrhythmic event, the remaining 10-15% being due to recurrent events.…”

Section: Description Of Underlying Health Problemmentioning

confidence: 99%

The clinical and cost-effectiveness of implantable cardioverter defibrillators: a systematic review

Bryant

Brodin²,

Loveman³

et al. 2005

Health Technol Assess

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“…Circadian patterns in the occurrence of .sudden arrhythmic death and ventricular arrhythmias are consistent with the potential role of increased sympathetic activity (2)(3)(4)(5). Data have steadily accumulated that indicate that attenuation and blockade of adrenergic drive lowers the propensity for sudden death in varying subsets of patients with cardiac disease (6)(7)(8)(9)(10)(11). This finding is particularly striking in the case of (3-adrenergic-blocking drugs, which have now been shown to decrease mortality in the survivors of acute myocardial infarction (MI) (6,9,10) and cardiac arrest (8) as well as in subsets of patients with congestive cardiac failure (12).…”

mentioning

confidence: 57%

“…Data have steadily accumulated that indicate that attenuation and blockade of adrenergic drive lowers the propensity for sudden death in varying subsets of patients with cardiac disease (6)(7)(8)(9)(10)(11). This finding is particularly striking in the case of (3-adrenergic-blocking drugs, which have now been shown to decrease mortality in the survivors of acute myocardial infarction (MI) (6,9,10) and cardiac arrest (8) as well as in subsets of patients with congestive cardiac failure (12). Decreased heart rate (HR) variability, seen in patient groups including those after MI and survivors of sudden cardiac death in whom sympathetic activity is increased, is an independent predictor of increased mortality (5).…”

mentioning

confidence: 99%

Effects of Sotalol on the Circadian Rhythmicity of Heart Rate and QT Intervals With a Noninvasive Index of Reverse-Use Dependency

Sharma¹,

Sarma²,

Singh³

1999

J Cardiovasc Pharmacol Ther

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BACKGROUND: The effects of sotalol on the 24-hour profile of the QT interval relative to that of the heart rate (HR) may be helpful in determining the time course of the drug's action in controlling cardiac arhythmias. This has not been previously determined. Thus, the objective of the current study was to evaluate the influence of the drug on the circadian rhythmicity of HR and QT intervals from Holter recordings in ambulatory patients. Reverse-use dependency (RUD) of sotalol was also studied noninvasively from Holter recordings. METHODS AND RESULTS: Holter recordings of 18 patients with ventricular arrhythmias were analyzed before and after 3-7 days of treatment with sotalol. We developed and used a signal processing system. A new noninvasive index to evaluate RUD was defined and applied to sotalol as a test agent. Sotalol significantly reduced HR from 76.9 +/- 3.2 to 60.0 +/- 1.1 (P <.001). The mean QT interval increased from 393 +/- 11 ms to 489 +/- 9 ms, whereas the mean normalized QT (QTc) interval increased from 415 +/- 5 ms to 487 +/- 5 ms (P <.001) during the drug treatment. Circadian rhythmicity of RR interval was abolished, but the circadian rhythms of the QT and QTc intervals were maintained during continuous treatment with sotalol. This finding is in contrast to amiodarone, which abolished the circadian rhythmicity of QTc interval while maintaining that of RR interval. RUD index was increased from 0.13 +/- 0.08 to 0.24 +/- 0.10 (P <.001) after sotalol, consistent with increased RUD with sotalol. CONCLUSIONS: The effects of sotalol on the circadian rhythmicity of HR and QTc interval are dissociated. They are in direct contrast to those reported for amiodarone, a difference that may be of clinical significance. The RUD index introduced here provides a noninvasive parameter for comparing short-term as well as long-term effects of class III antiarrhythmic drugs on RUD.

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Critical review of the approaches to the prevention of sudden death

Cited by 19 publications

References 34 publications

Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT

Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT

The clinical and cost-effectiveness of implantable cardioverter defibrillators: a systematic review

Effects of Sotalol on the Circadian Rhythmicity of Heart Rate and QT Intervals With a Noninvasive Index of Reverse-Use Dependency

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