Suppression of paroxysmal atrial tachyarrhythmias ? results of the SOPAT trial

Abstract

Taken together, anti-arrhythmic therapy with the fixed combination of Quinidine + Verapamil is as effective as Sotalol in the reduction of the recurrence rate of symptomatic PAF with a low but definite risk of severe side-effects.

Atrial high-rate episodes and stroke prevention

“…2 While AF typically presents with palpitations, dyspnoea, chest pain, and fatigue, it may also be asymptomatic. 5,6 Furthermore, atrial tachycardias (ATs) are heterogeneous in terms of the type of atrial arrhythmias, their duration, resulting ventricular rate and degree of irregularity, and underlying cardiovascular conditions.…”

New Antiarrhythmic Drugs and New Concepts for Old Drugs

“…52,53 Another fix combination that is in clinical development is a fix combination of dronedarone and ranolazine, which will have a stronger inhibitory effect on the late sodium current than dronedarone alone and add the multichannel-blocking properties of dronedarone to ranolazine monotherapy. A fix combination of verapamil and quinidine, another form of a multichannel blocker that has been used for many years in Germany, is as effective as sotalol for the prevention of atrial fibrillation but appears to provoke less proarrhythmia than quinidine alone: In the PAFAC and SOPAT trials, telemetric ECG monitoring detected one ventricular tachycardia in 895 patients treated with the quinidine-verapamil combination over one year compared with 8 episodes of torsades de pointes in 645 patients treated with sotalol over one year.…”

Atrial fibrillation in the elderly

“…In symptomatic patients, arrhythmic palpitation is a frequent complaint and may occur with syncope, angina, acute lung edema and/or systemic embolim. In general, cerebral or pulmonary and even symptomatic patients during AF episodes, do not notice their arrhythmia in more than half of the episodes during Holter analysis,[31],[32] thus making it difficult to clinically evaluate the presence and frequency of AF episodes. Asymptomatic arrhythmia does not mean lower risk of thromboembolic episodes and, very often, arrhythmia is diagnosed during or after stroke or transient ischemic attack.…”