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A. WALEFFE, K. NZAYINAMBAHO, L. M. RODRIGUEZ, A. DEHARENG, H. E. KULBERTUS, Mechanisms of termination of supraventricular tachycardias by intravenous class III antiarrhythmic agents. A comparison of amiodarone and sotalol, European Heart Journal, Volume 10, Issue 12, December 1989, Pages 1084–1089, https://doi.org/10.1093/oxfordjournals.eurheartj.a059430
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Abstract
The effects of amiodarone and sotalol were studied with programmed electrical stimulation of the heart in 19 patients with inducible tachycardia (AV nodal tachycardia: 10 cases, circus movement tachycardia: 9 cases). Amiodarone was administered intravenously at a dose of 300 mg over 2min and sotalol at a dose of 1.5 mg kg−1 over 10min. Both i.v. amiodarone and sotalol lengthened the transnodal conduction time, the effective refractory period of the AV node and the AV nodal Wenckebach cycle length. Only sotalol significantly lengthened the effective refractory periods of the right atrium and the right ventricle. Infused intravenously during tachycardia, amiodarone interrupted arrhythmia in five of six patients and sotalol in seven often cases. Tachycardia was stopped by blockade of the impulse into the AV node in three amiodarone patients and in five sotalol patients. In the remaining four cases, the weak link of the circuit was the accessory pathway. Thus i.v. sotalol exhibits electrophysiologic effects consistent with both class II and III activity, whereas the effects of i.v. amiodarone are the result of different activities throughout all areas of the cardiac tissue.
- amiodarone
- cardiac arrhythmia
- programmed electrical stimulation
- sotalol
- tachycardia
- atrioventricular accessory pathway
- atrioventricular node
- right atrium
- orthodromic circus-movement tachycardia
- refractory period
- mobitz type i incomplete atrioventricular block
- supraventricular tachycardia
- av junctional (nodal) tachycardia
- right ventricle
- heart
- accelerated atrioventricular conduction
- heart tissue
- class iii antiarrhythmic drug
- impulse