RESUMO
Chronic antiarrhythmic therapy for the prevention of episodes of paroxysmal supraventricular tachycardia is limited by its elevated cost, the development of side effects and lack of patients' collaboration. In this study the efficacy and safety of a single oral dose of diltiazem (180 mg) and propranolol (80 mg) were assessed. Eighteen episodes of supraventricular tachycardia were treated in 17 patients, 9 female and 8 male, aged between 19 and 60 years old (mean 45.3 +/- 11.4). The episodes had begun 3 months to 40 years before. They were divided in 3 groups: group I (placebo), 6 episodes; group II (diltiazem-propranolol), 12 episodes; and group III (patients from the placebo group without spontaneous recovery of sinus rhythm who were given active drug), 6 episodes. There were no spontaneous conversions in group I (placebo) within 80 minutes. In group II, ten out of 12 episodes responded to the combination after 38.8 +/- 20.8 minutes (seven episodes were converted to sinus rhythm within the first 45 minutes). In group III (non-responders to placebo who were subsequently given active drugs), four out of 6 episodes were suppressed after 50.7 +/- 16.7 minutes. The cycle of the tachycardia lengthened before conversion to sinus rhythm both in groups II and III. Neither systolic nor diastolic blood pressure changed significantly in any group. Seven out of 14 patients who successfully converted to sinus rhythm in groups II and III, suffered mild to moderate sweat between 3 and 5 minutes before the end of the episodes.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Diltiazem/administração & dosagem , Propranolol/administração & dosagem , Taquicardia Supraventricular/tratamento farmacológico , Administração Oral , Adulto , Combinação de Medicamentos , Eletrofisiologia , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Pessoa de Meia-IdadeRESUMO
El tratamiento crónico para prevenir la recurrencia de episodios de taquicardia supraventricular presenta el incoveniente del elevado costo, aparición de efectos adversos y escasa adherencia de los pacientes. En el presente estudio se evaluó la seguridad y eficacia de la combinación de ditiazem (180 mg) y propranolol (80 mg) en dosis única oral. Fueron incluidos 18 episodios de taquicardia supraventricular en 17 pacientes. La población fue dividida en 3 grupos I (placebo), 6 episodios; grupo II (droga activa), 12 episodios y grupo III (pacientes del grupo placebo en quienes, al no existir reversión a ritmo sinusal, se indicó diltiazem-propranolol), 6 episodios. No hubo ceses epontáneos de la arritmia en el grupo I (placebo) dentro de los 80 minutos. En el grupo II, 10 e 12 episodios fueron convertidos a ritmo sinusal a los 38,8 ñ 20,8 minutos post-droga. En el grupo III, 4 de 6 episodios fueron convertidos a ritmo sinusal a los 50,7 ñ 16,7 minutos post-droga activa. Dos pacientes tuvieron hipotensión arterial que no requirió tratamento específico. Es decir que 14 de 18 episodios revirtieron a ritmo sinusal con la combinación oral. Se concluye que el tratamiento episódico puede ser de utilidad en pacientes sin cardiopatía severa y con aceptable tolerancia hemodinámica durante las crisis
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Diltiazem/administração & dosagem , Propranolol/administração & dosagem , Taquicardia Supraventricular/tratamento farmacológico , Administração Oral , Eletrofisiologia , Frequência CardíacaRESUMO
Chronic antiarrhythmic therapy for the prevention of episodes of paroxysmal supraventricular tachycardia is limited by its elevated cost, the development of side effects and lack of patients collaboration. In this study the efficacy and safety of a single oral dose of diltiazem (180 mg) and propranolol (80 mg) were assessed. Eighteen episodes of supraventricular tachycardia were treated in 17 patients, 9 female and 8 male, aged between 19 and 60 years old (mean 45.3 +/- 11.4). The episodes had begun 3 months to 40 years before. They were divided in 3 groups: group I (placebo), 6 episodes; group II (diltiazem-propranolol), 12 episodes; and group III (patients from the placebo group without spontaneous recovery of sinus rhythm who were given active drug), 6 episodes. There were no spontaneous conversions in group I (placebo) within 80 minutes. In group II, ten out of 12 episodes responded to the combination after 38.8 +/- 20.8 minutes (seven episodes were converted to sinus rhythm within the first 45 minutes). In group III (non-responders to placebo who were subsequently given active drugs), four out of 6 episodes were suppressed after 50.7 +/- 16.7 minutes. The cycle of the tachycardia lengthened before conversion to sinus rhythm both in groups II and III. Neither systolic nor diastolic blood pressure changed significantly in any group. Seven out of 14 patients who successfully converted to sinus rhythm in groups II and III, suffered mild to moderate sweat between 3 and 5 minutes before the end of the episodes.(ABSTRACT TRUNCATED AT 250 WORDS)
RESUMO
El tratamiento crónico para prevenir la recurrencia de episodios de taquicardia supraventricular presenta el incoveniente del elevado costo, aparición de efectos adversos y escasa adherencia de los pacientes. En el presente estudio se evaluó la seguridad y eficacia de la combinación de ditiazem (180 mg) y propranolol (80 mg) en dosis única oral. Fueron incluidos 18 episodios de taquicardia supraventricular en 17 pacientes. La población fue dividida en 3 grupos I (placebo), 6 episodios; grupo II (droga activa), 12 episodios y grupo III (pacientes del grupo placebo en quienes, al no existir reversión a ritmo sinusal, se indicó diltiazem-propranolol), 6 episodios. No hubo ceses epontáneos de la arritmia en el grupo I (placebo) dentro de los 80 minutos. En el grupo II, 10 e 12 episodios fueron convertidos a ritmo sinusal a los 38,8 ñ 20,8 minutos post-droga. En el grupo III, 4 de 6 episodios fueron convertidos a ritmo sinusal a los 50,7 ñ 16,7 minutos post-droga activa. Dos pacientes tuvieron hipotensión arterial que no requirió tratamento específico. Es decir que 14 de 18 episodios revirtieron a ritmo sinusal con la combinación oral. Se concluye que el tratamiento episódico puede ser de utilidad en pacientes sin cardiopatía severa y con aceptable tolerancia hemodinámica durante las crisis (AU)