title: A randomised cross-over study on the haemodynamic effects of oral dofetilide compared with oral sotalol in patients with ischaemic heart disease and sustained ventricular tachycardia.
abstract: OBJECTIVE
  To assess the haemodynamic effects of short-term treatment with dofetilide in comparison with sotalol in patients with ischaemic heart disease.
  
  
  METHODS
  Twelve patients with ischaemic heart disease and sustained ventricular tachycardia were treated with dofetilide [500 microg twice daily (b.i.d.)] or sotalol (160 mg b.i.d., randomised sequence separated by wash-out period) for 3-5 days. Right-heart catheterisation was performed at baseline and at the end of each short-term treatment phase.
  
  
  RESULTS
  The main findings were a significant reduction in heart rate, mean systemic pressure and cardiac index (-13%) during treatment with sotalol. Conversely, cardiac index increased significantly during dofetilide (mean percentage change 11%) with no effect on heart rate and systemic blood pressure.
  
  
  CONCLUSIONS
  Oral dofetilide exerts favourable haemodynamic effects in comparison with D,L-sotalol following short-term oral treatment. In view of these observations, the use of dofetilide may be proposed also in patients with ventricular tachyarrhythmias associated with impaired left-ventricular function. Whether the haemodynamic differences between dofetilide and D,L-sotalol are the basis for differences in tolerability remains to be evaluated.
authors.affiliation: Institute of Cardiology, University of Bologna, Policlinico S. Orsola-Malpigni, Via Massarenti 9, 40138 Bologna, Italy. cardio1@almadns.unibo.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Boriani
authors.forename: Mauro
authors.initials: M
authors.lastname: Biffi
authors.forename: Letizia
authors.initials: L
authors.lastname: Bacchi
authors.forename: Cristian
authors.initials: C
authors.lastname: Martignani
authors.forename: Romano
authors.initials: R
authors.lastname: Zannoli
authors.forename: Ghazwan S
authors.initials: GS
authors.lastname: Butrous
authors.forename: Angelo
authors.initials: A
authors.lastname: Branzi
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D018592:Cross-Over Studies; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000188:drug therapy*; D010627:Phenethylamines / Q000008:administration & dosage / Q000627:therapeutic use*; D013015:Sotalol / Q000008:administration & dosage / Q000627:therapeutic use*; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use*; D014693:Ventricular Fibrillation / Q000150:complications / Q000188:drug therapy*
chemical_list: D000889:Anti-Arrhythmia Agents; D010627:Phenethylamines; D013449:Sulfonamides; D013015:Sotalol; C063533:dofetilide