Interaction of bisoprolol and procainamide in human cardiac impulse generation and conduction.
Combined treatment of beta-adrenoceptor-blocking agents and class I antiarrhythmic drugs can potentially have profound and deleterious effects on cardiac impulse formation and conduction. We studied the effect of 5 mg of oral bisoprolol daily and 10 mg/kg of procainamide intravenously with programmed electrical stimulation of the heart in 10 patients with postinfarction ventricular tachyarrhythmias. Oral bisoprolol slowed sinus rhythm and atrioventricular nodal conduction; ventricular effective refractory periods were increased significantly after several days of oral bisoprolol treatment. Combined treatment of oral bisoprolol and intravenous procainamide did not produce clinically relevant changes in parameters of cardiac impulse formation and conduction. This study shows that combined use of bisoprolol and a class I antiarrhythmic drug appears to be safe in patients with ventricular tachyarrhythrhythmias late after myocardial infarction.
Verrostte
J M
JM
Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
van Hemel
N M
NM
Kingma
J H
JH
D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001283:Atrioventricular Node / Q000187:drug effects / Q000502:physiology; D017298:Bisoprolol / Q000008:administration & dosage*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000187:drug effects*; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods; D006329:Heart Conduction System / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy; D011342:Procainamide / Q000008:administration & dosage*; D017180:Tachycardia, Ventricular / Q000188:drug therapy
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D011342:Procainamide; D017298:Bisoprolol