[Effect of sotalol on heart rate variability in patients with symptomatic, complex ventricular arrhythmias].
Heart rate variability (HRV) as determined from 24-h Holter recordings is being recognized as a measure of cardiac autonomic control. In patients surviving myocardial infarction HRV has been established as a useful tool for risk-stratification. The effects of antiarrhythmic agents on HRV, however, have not been extensively studied. The present study therefore examined time- and frequency-domain measures of HRV in 28 patients (10 females, 18 males at a mean age of 59 +/- 15 years) with symptomatic complex ventricular arrhythmias (> 30 VPB/h plus repetitive arrhythmias) before and during treatment with sotalol, a beta-receptor blocking agent with class-III antiarrhythmic activity. Heart rate variability before treatment was independent of the density of spontaneous arrhythmias. Therapy with sotalol resulted in a significant improvement in indices of vagal tone compared to baseline (SDNN 113 +/- 45 vs. 99 +/- 43 ms (p = .05); rMSSD 39 +/- 23 vs. 30 +/- 17 ms (p = .009); pNN50 11.4 +/- 12.5 vs. 6.8 +/- 9.5% (p = .005); HF 13 +/- 7 vs. 11 +/- 7 (p = .048). This improvement was particularly evident in patients with reduced left ventricular function (LVEF < 40%) and was independent of therapy-induced changes in mean heart rate (pNN50 vs. Mean NN r = 0.37; n.s.) or suppression of ventricular arrhythmias (pNN50 vs. In VES/24 h r = 0.41; n.s.). These effects on heart rate variability and thus on cardiac autonomic tone may contribute significantly to the antifibrillatory efficacy profile of sotalol.
Klingenheben
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Medizinische Universitätsklinik III, Kardiologie und Angiologie, Freiburg.
Hohnloser
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D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000187:drug effects / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D015716:Electrocardiography, Ambulatory / Q000187:drug effects*; D005260:Female; D006321:Heart / Q000294:innervation; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013015:Sotalol / Q000009:adverse effects / Q000627:therapeutic use*; D017180:Tachycardia, Ventricular / Q000188:drug therapy* / Q000503:physiopathology; D014630:Vagus Nerve / Q000187:drug effects / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology
D013015:Sotalol
Effekt von Sotalol auf die Herzfrequenzvariabilität bei Patienten mit symptomatischen, komplexen ventrikulären Arrhythmien.