Enhanced antiarrhythmic efficacy of propafenone when used in combination with procainamide or quinidine |
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| Authors: | R C Klein S K Huang F I Marcus L Horwitz P E Fenster N Rushforth E B Kirsten |
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| Affiliation: | 1. Cardiology Division participating in the Southwest Cardiology Research Group. Veterans Administration Medical Center, Albuquerque, N.M., USA;2. Cardiology Division the University of New Mexico, Albuquerque, N.M., USA;3. University of Arizona Health Sciences Center, Tucson, Ariz., USA;4. University of Colorado Health Sciences Center, Denver, Colo., USA;1. Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota;2. Franchise Health Economics and Market Access, Johnson & Johnson Medical Devices, Irvine, California;3. MedTech Epidemiology & Real World Data Sciences, Johnson & Johnson, New Brunswick, New Jersey;1. ICN Business School and CEREFIGE, Nancy 86 Rue du sergent Blandan, 54000, Nancy, France;2. Karlshochschule International University and ICN Business School, Karlstraße, 36-38, 76133, Karlsruhe, Germany;3. Hôpitaux universitaires, Strasbourg and AHP-PReST, Université de Strasbourg, Université de Lorraine, CNRS, 1 place de l’Hôpital, 67091, Strasbourg, France;1. Hospital Universitario de Torrevieja, Alicante, Spain;2. Hospital Universitario de Elche Vinalopó, Universidad Católica de Murcia, Alicante, Spain;3. Grupo HM Hospitales, Universidad CEU San Pablo, Madrid, Spain |
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| Abstract: | This study evaluated the efficacy and safety of combining propafenone with procainamide or quinidine for treating ventricular arrhythmias in patients in whom procainamide or quinidine therapy alone failed to suppress arrhythmias. In 30 patients, the addition of propafenone resulted in a significant reduction of premature ventricular contraction (PVC) frequency compared to drug-free baseline (406 PVC/hr vs 33, p less than 0.001) and to procainamide or quinidine monotherapy (211 PVC/hr vs 27, p less than 0.01). Propafenone alone was also more effective than either procainamide or quinidine and resulted in significant suppression of PVC compared to the drug-free state (406 PVC/hr vs 38, p less than 0.001). However, higher propafenone doses were necessary during monotherapy as compared to propafenone therapy combined with procainamide or quinidine (730 mg/day vs 480 mg/day, p less than 0.001). Of the 30 patients, 22 required an increase in propafenone dose during monotherapy as compared to combination therapy. Thus, propafenone is an effective antiarrhythmic agent when used in combination with type IA antiarrhythmic drugs. With these combinations, lower doses of propafenone can be utilized effectively than with propafenone alone. |
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