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European Heart Journal 1987 8(4):372-377;
Copyright © 1987 by the European Society of Cardiology.
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© 1987 The European Society of Cardiology

Effects of intravenous sotalol, aprindine and the combination of sotalol and aprindine on chronic high frequency ventricular arrhythmias in man

R. STROOBANDT*,, G. HOLVOET*, N. VERBEKE{dagger} and H. KESTELOOT{ddagger}

*Department of Cardiology, St Jozef Hospital Oostende, Belgium
{dagger}Department of Galenic and Clinical Pharmacy Leuven, Belgium
{ddagger}Department of Cardiology, University Hospital, St Rafaël Leuven, Belgium

Received 21 April 1986; revised 9 September 1986; .

Address for correspondence. R. Stroobandt MD, Department of Cardiology, St Jozef Hospital, B-8400 Oostende, Belgium

Abstract

The comparative aniiarrhythmic efficacy of three different intravenous drug regimens was evaluated in 12 symptomatic patients (mean age: 72 years) with chronic high frequency ventricular arrhythmias (mean: 834 PVCs h–1). In a cross-over study with latin square distribution the following drug regimens were administered intravenously to all patients (a) aprindine 2 mg kg–1, (b) sotalol 1.5 mg kg–1, (c) aprindine 1 mg kg–1 & sotalol 0.75 mg kg–1. The mean percentage of PVC reduction was 41% (P <0.05) for aprindine 2 mg kg–1; 51% (P <0.05) for sotalol 1.5 mg kg–1 and 72% (P <0.01) for the combined drug therapy (aprindine 1 mg kg–1 and sotalol 0.75 mg kg–1). The mean plasma concentration was 1371 ng ml–1 after administration of aprindine 2 mg kg–1 and 1730 ng ml–1 after infusion of sotalol 1.5 mg kg–1. After combined drug therapy, mean plasma levels were 942 ng ml–1 for aprindine and 992 ng ml–1 for sotalol. The different drug regimens were well tolerated in all patients and no side-effects occurred. Combination therapy consisting of a drug that prolongs action potential duration with an antiarrhythmic agent that has a high affinity for the inactivated channels may thus achieve an antiarrhythmic efficacy comparable to single agent therapy, permitting the use of lower dosages.

Key Words: Aprindine • sotalol • antiarrhythmic drugs • ventricular arrhythmias • drug combinations


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