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- W2023542569 abstract "Sotalol Plus Quinidine and Torsades de Pointes. Introduction: Clinical treatment with a combination of Class IA and III antiarrhythmic drugs is not recommended, as they both favor bradycardia-dependent proarrhythmic events such as torsades de pointes (TdP). However, this theoretical additive effect on ventricular repolarization has never heen demonstrated and could be questioned as other Class I drugs, such as mexiletine, a Class IB drug, limit the number of sotalol-induced TdP in dogs with AV block, suggesting the possibility of an antagonistic action of Class I properties against Class III effects. Methods and Results: We compared the electrophysiologic and proarrhythmic effects of sotalol (Class III) alone and combined with quiuidine (Class IA) in a canine model of acquired long QT syndrome. Seven hypokalemic (K*: 3 ± 0.1 mEq/L) dogs with chronic AV block had a demand pacemaker implanted and set at a rate of 25 beats/min. They were submitted to two (sotatol-alone and sotalol-plus-quinidine) experiments 48 bours apart usiug a randomized cross-over protocol. They were pretreated with quinidine (10 mg/kg + 1.8 mg/kg per hour) or saline infused throughout the experiment, aud given sotalol (4.5 mg/kg + 1.5 mg/kg per hour) for 2 hours, 30 minutes after the beginning of the pretreatment infusion during both experiments. Ventricular and atrial cycle lengths were similarly increased by sotalol after quinidine or saline. The sotalol-induced prolongation of the QT interval was significantly shorter in quinidine-pretreated dogs (24 ± 7 msec after quinidine vs 40 ± 8 msec after saline). Fewer dogs developed TdP: significantly during the first hour of infusion (1/7 sotalol-plus-quinidine vs 6/7 sotalol-alone dogs, P < 0.05) but nonsignificantly during the second hour (3/7 vs 6/7). Conclusion: In this model, the sotalol-plus-quinidine combination is at least no more arrhythmogenic than either of the drugs given alone." @default.
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- W2023542569 date "1998-05-01" @default.
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- W2023542569 title "Combination of Sotalol and Quinidine in a Canine Model of Torsades de Pointes." @default.
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- W2023542569 doi "https://doi.org/10.1111/j.1540-8167.1998.tb01842.x" @default.
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