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ADEG
Antiarrhythmic Drug Evaluation Group
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Author(s) |
(a) Zuanetti G, Latini R, Neilson JMM, Schwartz PJ,
Ewing DJ
(b) Antiarrhythmic Drug Evaluation Group
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Title(s) |
(a) Heart rate variability in patients with ventricular arrhythmias: effect of antiarrhythmic drugs
(b) A multicentre, randomised trial on the benefit/risk profile of amiodarone, flecainide and propafenone in patients with cardiac disease and complex ventricular arrhythmias
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Reference(s) |
(a) J Am Coll Cardiol 1991;17:604-12
(b) Eur Heart J 1992;13:1251-8
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Disease |
Ventricular arrhythmia, cardiac disease
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Purpose |
To compare the long-term benefit/risk profiles of flecainide, propafenone and amiodarone in patients with complex ventricular arrhythmias and heart disease and to study the effect of the drugs on heart rate variability
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Study design |
Randomised, open, parallel-group, partly crossover
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Follow-up |
2 years
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Patients |
141 patients, mean age 59 years. 109 (77%) completed the study. 40 patients entered a washout protocol
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Treatment regimen |
Flecainide, 200 or 450 mg/day, or propafenone, 300 or 900 mg/day, or amiodarone, 200-400 mg/day, after an initial loading dose of ≥ 600 mg/day for 1 week
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Results |
After 2 years, of the 76 patients (54%) responding, 60 never changed drug (49% of those given amiodarone, 46% of those given flecainide and 30% of those given propafenone, as first drug). There were 50 adverse reactions resulting in drug withdrawal (17% of the amiodarone group, 21% of the flecainide group and 35% of the propafenone group). Cardiovascular adverse events were significantly less common with amiodarone (p < 0.03). The different effects of the drugs on heart rate variability may contribute to their overall effect on mortality
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