Effects of amiodarone studied by programmedelectrical stimulation of the heart in patients with paroxysmal re-entrant supraventricular tachycardia

Waleffe, A.; Bruninx, Patrick; Kulbertus, H

doi:10.1016/s0022-0736(78)80125-3

Cited by 42 publications

(2 citation statements)

References 11 publications

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“…The effect of intravenous and oral amiodarone was studied as follows: amiodarone was given intravenously in 1 min with a dosage of 5 mg/kg body weight. Thereafter, the electrophysiologic parameters were measured immediately, 10,20, and 30 min after administration of the drug. Each set of measurements lasted approximately 5 min.…”

Section: Methodsmentioning

confidence: 99%

A comparison of the electrophysiologic effects of intravenous and oral amiodarone in the same patient.

Wellens¹,

Brugada²,

Abdollah³

et al. 1984

Circulation

129

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In 12 patients (nine with Wolff-Parkinson-White syndrome and three with ventricular tachycardia) the electrophysiologic effects of intravenous (5 mg/kg body weight in 1 min) and oral (total dose 9800 to 11,200 mg) amiodarone were studied with programmed stimulation of the heart. Intravenous and oral amiodarone had a similar (p < .05) effect of lengthening on the effective refractory period of the atrioventricular node. Only intravenous amiodarone prolonged (p < .05) the AH interval. Oral amiodarone was more effective than intravenous amiodarone in lengthening the anterograde effective refractory period of the accessory atrioventricular pathway. Only oral amiodarone prolonged the effective refractory period of atrium and ventricle and the HV interval, all significantly (p < .05). Intravenous amiodarone slowed (p < .05) the rate of circus-movement tachycardia in patients with Wolff-Parkinson-White syndrome, and further slowing was observed after oral amiodarone. Termination of tachycardia by intravenous amiodarone predicted prevention of reinitiation of tachycardia during oral amiodarone. These data indicate that intravenous and oral amiodarone do not have the same electrophysiologic effects. It is not clear whether cumulative effects, active metabolites, or both are responsible for these differences.Circulation 69, No. 1, 120-124, 1984. IT HAS BEEN established that amiodarone administered orally is a very powerful drug for the treatment of arrhythmias occurring at the supraventricular and ventricular level.1`8 Although its mechanism of action at the cellular level is not quite clear, the electrophysiologic effects of oral amiodarone have been well studied.2', 915 A major problem in using oral amiodarone is the necessity of giving the drug for several days to weeks before it can reach its maximal effect. This limits its use in patients in whom an immediate antiarrhythmic effect is required. The introduction of intravenous amiodarone'6 was therefore received with great interest.In this article we report on the comparison between the electrophysiologic effects of intravenous and oral amiodarone. During programmed stimulation of the heart, we studied the effects of intravenous amiodarone in 12 patients. In the same patients the same stimu- 120 lation program was repeated 5 to 6 weeks after administration of oral amiodarone. Materials and methodsTwelve patients were studied, and their clinical data are given in table 1. After informed consent was obtained, a study of programmed stimulation was performed. Our methods of stimulation and recording and our definitions of the different electrophysiologic parameters have been reported previously.'7The following measurements were made: (1) heart rate during sinus rhythm, (2) the effective refractory period of the right atrium, (3) the effective refractory period of the right ventricle, (4) the effective refractory period of the atrioventricular (AV) node, (5) the refractory period of the accessory AV pathway (in the nine patients with Wolff-Parkinson-White synd...

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Section: Methodsmentioning

confidence: 99%

A comparison of the electrophysiologic effects of intravenous and oral amiodarone in the same patient.

Wellens¹,

Brugada²,

Abdollah³

et al. 1984

Circulation

129

View full text Add to dashboard Cite

show abstract

“…If a class 1 action operates in human atrial muscle in vivo then amiodarone-treated patients might be expected to display slowing of intra-atrial conduction. Indeed, some investigators have found such a slowing (Coutte et al, 1976;Touboul et al, 1976b;Waleffe, et al, 1978), albeit sometimes only a slight slowing and one which was not always statistically significant (Finerman et al, 1982). The relevant literature has been reviewed recently by Camm & Bexton (1983).…”

Section: Discussionmentioning

confidence: 98%

Alterations to the electrical activity of atrial muscle isolated from the rat heart, produced by exposure in vitro to amiodarone

Northover

1984

British J Pharmacology

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Clinical use of antiarrhythmic drugs

Gettes¹,

Foster²,

SimpsonJr.³

1983

Cardiac Therapy

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Effects of amiodarone studied by programmedelectrical stimulation of the heart in patients with paroxysmal re-entrant supraventricular tachycardia

Cited by 42 publications

References 11 publications

A comparison of the electrophysiologic effects of intravenous and oral amiodarone in the same patient.

A comparison of the electrophysiologic effects of intravenous and oral amiodarone in the same patient.

Alterations to the electrical activity of atrial muscle isolated from the rat heart, produced by exposure in vitro to amiodarone

Clinical use of antiarrhythmic drugs

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