Pharmacotherapy in inherited and acquired ventricular arrhythmia in structurally normal adult hearts

Ortmans, Staniel; Daval, Charline; Aguilar, Martín; Compagno, Pablo; Cadrin‐Tourigny, Julia; Dyrda, Katia; Rivard, Léna; Tadros, Rafik

doi:10.1080/14656566.2019.1669561

Cited by 8 publications

(8 citation statements)

References 110 publications

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“…β-blockers by their anti-sympathomimetic activity decrease the etiology of cardiac arrhythmias/ACE in LQTS as sympathetic activity increases the risk of these events [5,27,28]. [22]. Notably and understandably, no two β-blockers are the same and have varying pharmacodynamic and kinetic effects that show their efficacy in varying subtypes [28,29].…”

Section: β-Blockers and Lqtsmentioning

confidence: 99%

“…emphasized the efficacy and role of nadolol in LQTS 3, where previously β-blockers were thought to be contraindicated[5]. Winbo et al despite focusing on sympathetically triggered arrhythmia syndromes concluded that the provided non-selective β-blockers are more efficient in reducing arrhythmia risk than beta 1 selective such as metoprolol or bisoprolol[21].Etheridge et al, Ackerman et al, and Ortmans et al had similar conclusions as Saadeh et al supporting non-selective βblockers such as nadolol and propranolol as first-line treatment options[5,6,13,22] Wilde et al in 2016. provided the largest multicenter cohort study on LQT3, and their conclusions led to the recommendation of nadolol as the first line for this subtype…”

mentioning

confidence: 91%

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A Systematic Review on the Role of Βeta-Blockers in Reducing Cardiac Arrhythmias in Long QT Syndrome Subtypes 1-3

Went¹,

Sultan²,

Sapkota³

et al. 2021

Cureus

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Long QT syndrome (LQTS) is one of the most common inherited cardiac channelopathies with a prevalence of 1:2000. The condition can be congenital or acquired with 15 recognized genotypes; the most common subtypes are LQTS 1, 2, and 3 making up to 85%-90% of the cases. LQTS is characterized by delayed ventricular cardiomyocyte repolarization manifesting on the surface electrocardiogram (EKG) by a prolonged corrected QT (QTc) interval. The mainstay of treatment for this condition involves in part or combination medical therapy via β-blockers as first-line (or other anti-arrhythmic), left cardiac sympathectomy, or implantable cardiac defibrillator placement. Given the high rate of adverse cardiac events (ACE) or sudden cardiac death (SCD) in this population of patients with this disease, this review seeks to highlight the genotype-specific treatment consensus in β-blocker therapy of the most common subtypes.A database search of PubMed, PMC, and Medline was conducted to ascertain the most recent data in the last five years on the management of LQTS types 1-3 and the role of β-blockers in reducing ACE in these types. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adhered to in the study selection, and selected studies focused on humans, written in the English Language, and within the last five years of LQTS subtypes 1, 2, and 3.Eleven relevant studies were selected after considering inclusion criteria, exclusion criteria, and quality appraisal within the last five years, focusing on β-blocker selection directed based on the subtypes of LQTS. Two meta-analyses, one cohort study, and eight reviews provided significant data that non-selective βblockers unequivocally are of benefit in these LQTS types. Summary of findings suggested nadolol followed by propranolol yields the best results in LQTS 1, while nadolol would yield the best effect in LQTS 2 and 3.

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Section: β-Blockers and Lqtsmentioning

confidence: 99%

mentioning

confidence: 91%

A Systematic Review on the Role of Βeta-Blockers in Reducing Cardiac Arrhythmias in Long QT Syndrome Subtypes 1-3

Went¹,

Sultan²,

Sapkota³

et al. 2021

Cureus

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“…Eine zunehmend wichtigere Rolle spielen Klasse-I-Antiarrhythmika bei genetisch bedingten Arrhythmien [12]. Hierzu gehören die Behandlung von Patienten mit polymorphen katecholaminergen Kammertachykardien mit Flecainid sowie die Therapie von Patienten mit speziellen Formen des Longs-QT-Syndroms mit Mexiletin und anderen Lokalanästhetika.…”

Section: Andere Arrhythmienunclassified

“…Ähnlich problematisch ist die Versorgungssituation bei Chinidin, das in Deutschland ebenfalls nicht mehr im Handel ist. Die Substanz ist bei Patienten mit Brugada gut geeignet, elektrische Stürme zu terminieren und die Zahl von ICD-Einladungen aufgrund häufiger ventrikulärer Tachyarrhythmien zu reduzieren [12]. Über die internationale Apotheke kann die Substanz weiterhin bezogen werden.…”

Section: Andere Arrhythmienunclassified

Therapie von Herzrhythmusstörungen mit Antiarrhythmika: kein Ende einer Ära

Haverkamp

2020

Aktuelle Kardiologie

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ZusammenfassungAntiarrhythmika sind eine Medikamentengruppe, die vor mehr als 100 Jahren eingeführt wurde. Jahrzehntelang wurden sie relativ breit und großzügig eingesetzt. Die Erkenntnis, dass proarrhythmische Effekte relativ häufig sind, und die Entwicklung neuer nicht medikamentöser Behandlungsalternativen (z. B. die Katheterablation bei Vorhofflimmern) haben dazu geführt, dass sich ihr klinischer Stellenwert in den letzten Jahren geändert hat. Schon seit Längerem wird das Ende der Antiarrhythmikaära prophezeit. In der Realität ergibt sich allerdings ein anderes Bild. Registerdaten zeigen, dass fast die Hälfte der Patienten mit Vorhofflimmern, die sich einer Katheterablation unterziehen, im weiteren Verlauf ein Antiarrhythmikum erhält. Eine unverändert wichtige Rolle spielen Antiarrhythmika (insbesondere Amiodaron) auch im Notfall und bei Patienten mit häufigen malignen ventrikulären Arrhythmien. Einen zunehmend relevanter werdenden Anwendungsbereich stellen angeborene Arrhythmien (langes-QT-Syndrom, Brugada-Syndrom, katecholaminerge polymorphe Kammertachykardien) dar. Antiarrhythmika gehören damit weiterhin zum Armamentarium des rhythmologisch orientierten Arztes. Es darf gehofft werden, dass neue Formen des EKG- und Patienten-Monitorings (z. B. Smartphone-EKGs) dazu betragen werden, die Überprüfung der Therapiewirksamkeit zu vereinfachen und die Therapiesicherheit zu optimieren.

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“…ere are usually incomplete compensatory intervals after pre-phase contraction of room type [16][17][18]. Detection of P wave is of great significance to ECG analysis of arrhythmia and analysis of characteristic points of ECG signal.…”

Section: Introductionmentioning

confidence: 99%

Dynamic Electrocardiogram under P Wave Detection Algorithm Combined with Low-Dose Betaloc in Diagnosis and Treatment of Patients with Arrhythmia after Hepatocarcinoma Resection

Jiang

Shi

et al. 2021

Journal of Healthcare Engineering

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This work aimed to study the diagnostic value of dynamic electrocardiogram (ECG) based on P wave detection algorithm for arrhythmia after hepatectomy in patients with primary liver cancer, and to compare the therapeutic effect of different doses of Betaloc. P wave detection algorithm was introduced for ECG automatic detection and analysis, which can be used for early diagnosis of arrhythmia. Sixty patients with arrhythmia after hepatectomy for primary liver cancer were selected as the research objects. They were randomly divided into control group, SD group, MD group, and HD group, with 15 cases in each group. No Betaloc, low-dose (≤47.5 mg), medium-dose (47.5–95 mg), and high-dose (142.5–190 mg) Betaloc were used for treatment. As a result, P wave detection algorithms can mark P waves that may be submerged in strong interference. P waves from arrhythmia database were used to verify the performance of the proposed algorithm. The prediction precision (Pp) of ventricular arrhythmia and atrial arrhythmia was 98.53% and 98.76%, respectively. Systolic blood pressure (117.35 ± 7.33, 126.44 ± 9.38, and 116.02 ± 8.2) mmHg in SD group, MD group, and HD group was significantly lower than that in control group (140.3 ± 7.21) mmHg after two weeks of treatment. Moreover, those of SD group and HD group were significantly lower than MD group ( P < 0.05 ). The effective rate of cardiac function improvement in SD group (72.35 ± 1.21%) was significantly higher than that in control group, MD group, and HD group (38.2 ± 0.98%, 65.12 ± 1.33%, and 60.43 ± 1.25%; P < 0.05 ). In short, dynamic ECG based on P wave detection algorithm had high diagnostic value for arrhythmia after hepatectomy in patients with primary liver cancer. It was safe and effective for patients to choose small dose of Betaloc.

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Pharmacotherapy in inherited and acquired ventricular arrhythmia in structurally normal adult hearts

Cited by 8 publications

References 110 publications

A Systematic Review on the Role of Βeta-Blockers in Reducing Cardiac Arrhythmias in Long QT Syndrome Subtypes 1-3

A Systematic Review on the Role of Βeta-Blockers in Reducing Cardiac Arrhythmias in Long QT Syndrome Subtypes 1-3

Therapie von Herzrhythmusstörungen mit Antiarrhythmika: kein Ende einer Ära

Dynamic Electrocardiogram under P Wave Detection Algorithm Combined with Low-Dose Betaloc in Diagnosis and Treatment of Patients with Arrhythmia after Hepatocarcinoma Resection

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