Combined anti-arrhythmic therapy with class 1 and class 3 drugs.
This study was designed to investigate the differences in efficacy between 3 different combinations of amiodarone and a class 1 anti-arrhythmic drug (one from each class). The purpose was to determine whether the known differing electrophysiological properties of class 1 drugs result in any particular one making a superior combination with the class 3 drug amiodarone. Eight patients were studied in a randomized single blind cross-over trial. Amiodarone and flecainide proved to be the superior combination producing a significantly greater reduction in mean ectopic counts/24 hours than the amiodarone/mexilitene combination (1,286 vs 3,243; P less than 0.05) or the amiodarone/disopyramide combination (3,795; P less than 0.05). All 3 combinations reduced mean ectopic counts from the baseline value (8,729), but this was only significant for amiodarone/flecainide (P less than 0.01) and amiodarone/mexilitene (P less than 0.05). In addition the amiodarone/flecainide combination produced a significant reduction in complex forms of arrhythmia with ventricular tachycardia abolished in all cases, which was not achieved by any other combination.
James
M A
MA
Department of Cardiology, Bristol Royal Infirmary, UK.
Papouchado
P
P
Jones
J V
JV
D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000145:classification; D004206:Disopyramide / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D005424:Flecainide / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008801:Mexiletine / Q000008:administration & dosage; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D016037:Single-Blind Method
D000889:Anti-Arrhythmia Agents; D008801:Mexiletine; D004206:Disopyramide; D005424:Flecainide; D000638:Amiodarone