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Comparisons of Sotalol and Amiodarone on Exercise Electrocardiology and Physiology in Patients withous Structural Heart Disease

Author: XieXiaoJie
Tutor: WangJianAn；ShaZhenQiu
School: Zhejiang University
Course: Internal Medicine ( Cardiovascular Disease )
Keywords: Sotalol Amiodarone Exercise treadmill test
CLC: R540.41
Type: Master's thesis
Year: 2001
Downloads: 76
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Abstract

A. Introduction Search sotalol (sotalol) and amiodarone (amiodarone) class III antiarrhythmic drugs, the former both non-selective beta-receptor blockade. Many large-scale clinical studies prove that both have a good effect on a variety of arrhythmias, can reduce the rate of recurrence of arrhythmia and sudden cardiac death rate, compared with class I drugs, long-term use does not affect survival, Current clinical treatment of arrhythmia compared to an ideal drug. Cable he Loehr and amiodarone major role in myocardial cell action potential of 2,3-phase, prolong repolarization and effective refractory period (effective refractory period, ERP), prolonged action potential duration (action potential Duration APD) electrophysiological examination prompted cable sotalol with inverse frequency dependent effects (reverse use dependent effect), that prolonged action potential process of antiarrhythmic drugs in heart rate weakened, the performance of the action potential duration, especially repolarization of time to shorten. Sotalol and amiodarone electrophysiological mechanism in recent years, pharmacokinetics and clinical efficacy have been many studies, but in the state of the campaign, both the electrophysiological effects and safety has not been reported. Many studies have confirmed that the exercise test reflects the electrophysiological mechanisms of the anti-arrhythmic drugs, efficacy and safety. The trial was the first by a treadmill exercise test (treadmill test) concept Chasuo the sotalol and amiodarone in exercise physiology state exercise ECG and hemodynamic effects compared to investigate the (1) in the state of motion of both the repolarization Comparison of the effect of ventricular conduction, atrioventricular; (2) compare both affect myocardial oxygen consumption, exercise time, heart rate reserve and exercise tolerance; (3) to evaluate the efficacy and safety of both in the state of motion. Journal of Zhejiang University. Subjects and methods. Object of study; July 2000 to January 2001 due to occasional palpitations or premature ventricular contractions Affiliated to Zhejiang University, Sir Run Run Shaw Hospital, Department of Cardiology, the treatment of patients. By history, physical examination, routine laboratory tests, three slices of heart, body surface 12-lead ECG, echocardiography, 24-hour ambulatory ECG laboratory examinations found no evidence of structural heart disease. Exclude (1) WPW syndrome or bundle branch block induced QRS widening; (2) treadmill exercise test showed ischemic ST-segment depression 30. Ind; (3) 24-hour Holter prompt sinus node or atrioventricular node function abnormalities; (4) echocardiography suggestive of structural heart disease; ⑤ into the test within a week had applied the antiarrhythmic Standing drugs; 3 hypertension systolic blood pressure less than 90 sick; ⑤ respiratory or motion system and other systemic disease; (3) prior to study entry. mHgHR heart rate less than 60 beats / min. Met the inclusion criteria and complete all the test cases of 31 patients, male 23 cases, 8 females, age 23-59 years old U7, 81t9, 01). 2. Methods: A single-blind, self-controlled principle. Each patient for the first time not taking any medication treadmill exercise test was used as a blank control. Oral sotalol still 0. y, 2 times / medication 3R according to a second inspection. 4 days after the withdrawal of each patient into the next inspection. Third treadmill exercise test deleted in oral amine, ketone 6001; ig / day. 3 times / day, 1 week after medication. 3 times a treadmill exercise test is basically at the same time, operating by the same doctor. All patients do not know pharmaceutical ingredients. Disabled patients entered the study prior to cardiovascular drugs at least five and a half mourning period and during the study should not be taken to affect sotalol and amiodarone pharmacokinetics of other drugs (such as cisapride treadmill exercise test using standard B. CE programs and symptoms limiting symptom-h ITD) 'termination criteria. Exercise test in a 12-lead simultaneous ECG and blood pressure were recorded every movement before the end of the sport at all levels 1 minutes (3 minutes / level), peak exercise, every two minutes of the end of the exercise ECG, simultaneous measurement of blood pressure, until the Chuan minutes after exercise, record exercise time. ECG measurements in the same patient, fixed in the the same precordial heart l. h FIG recorded!) A 50nl; n / s. Heart rate to speed up the course of the campaign, the P wave easy and its T wave descending artery integration QT interval measurement method using the earliest starting point from Q-wave to the peak of the T wave. The factory interval for the bite with talk of the difference of time for S. Stare, a few of correction method using pr. mh noisy. . Heart Research Center, improved bite interval correction formula A pair of two balcony River. The u4 door-m) and Plant C Plant 10, U4 Bu called), the two Zhejiang University, a master's degree gun husband QTc and JTc. Selection of SPSS10.0 for Windows statistical package for statistical processing of all the information, the measurement data are mean ± standard deviation a SD). Normal distribution and homogeneity of variance test data. Variance Qi, normally distributed data, the comparison between treatment groups using a randomized block variance analysis, meaningful groups to LeastSignificant Differences (LSD) and Student-Newman-Keuls (SNK) method between two groups In comparison, the comparison of the treatment group using paired t tests; variance arrhythmia, non-normal distribution of data using non-parametric tests. a = 0.05, two-sided test. P <0.05 as statistically significant difference level. III. Results 1. Sotalol and amiodarone significantly reduce static and exercise levels, heart rate (P (.01) service sotalol when static and peak exercise heart rate were 65.65 ± 6.13 beats / min [] 146 .81 I14.47 beats / min with before treatment comparison (85.3 calendar .02 / min and 183.71 u.12 / min), the K0.001 amiodarone static and peak exercise heart rate were 75.1315.927k / 5} 164.77 9.93 times / min, l '(.001 serving cable the sotalol 6ZJ peak exercise and static heart rate was significantly lower than amiodarone (KO OI). oral cable sotalol heart rate reserve \

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