Skip to main content

Klinisch-elektrophysiologische Effekte von Amiodaron bei bedrohlichen ventrikulären Tachyarrhythmien

  • Conference paper
Book cover Lebensbedrohliche ventrikuläre Herzrhythmusstörungen

Zusammenfassung

Amiodaron, ein Benzofuranderivat, wurde 1961 bei Labaz entwickelt (1, 2) und ursprünglich als antianginöse wirksame Substanz in die Klinik eingeführt (3, 4). Erst später wurden die potenten antiarrhythmischen Eigenschaften der Substanz bekannt, die der Klasse III nach Vaughan-Williams zuzuordnen sind (5–7). Inzwischen liegen zahlreiche Studien vor, die die Wirksamkeit von Amiodaron bei einer Vielzahl therapierefraktärer supraventrikulärer und ventrikulärer Tachyarrhythmien belegen (8–32). Die pharmakologischen Eigenschaften von Amiodaron mit einer langen Halbwertzeit erleichtern zwar die chronische Einnahme, bedingen andererseits aber auch Probleme bei der Wahl seiner optimalen Aufsättigungs- und Erhaltungsdosis. Diese komplexen Zusammenhänge und die potentiell ernsten Nebenwirkungen (16, 33–34) lassen Amiodaron zu einer Sustanz werden, die nur bei bedrohlichen Tachyarrhythmien, die sich gegenüber anderen, konventionellen Antiarrhythmika als ineffektiv erwiesen haben, eingesetzt werden sollte.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Charlier R, Deltour G, Tondeur R, Binon F (1962) Recherches dans la serie des benzofurannes. VII. Etude pharmacoligique préliminaire due butyl-2 (diiode-3′, 5′-beta-N-diethylamino-ethoxy-4′ benzoyl)-3 bezonfu- ranne. Arch Intern Pharmacodyn Ther 139: 255–264

    CAS  Google Scholar 

  2. Charlier R, Delaunois G, Bautheri J et al (1969) Dans la serie des benzofurannes. XL. Properties antiarrhythmiques de amiodarone. Cardiologia 54: 82

    Article  Google Scholar 

  3. Charlier R, Deltaur G, Baudine A (1968) Pharmacology of amiodarone, an antianginal drug with new biologic profile. Arzneimittelforsch 18: 1408

    PubMed  CAS  Google Scholar 

  4. Vastesaeger M, Gillot P, Rassons G (1967) Etude clinique d’une nouvelle médication antiangoreuse. Acta Cardiol (Belgium) 22: 483: 500

    Google Scholar 

  5. Singh B, Vaughan Williams E (1970) The effect of amiodarone, a new antianginal drug on cardiac muscle. Br J Pharmacol 39: 657

    PubMed  CAS  Google Scholar 

  6. Rosenbaum M, Chiale P, Halpern M (1976) Clinical efficacy of amiodarone as an antiarrhythmic agent. Am J Cardiol 38: 934

    Article  PubMed  CAS  Google Scholar 

  7. Sing BN, Collet J, Chow C (1980) New perspectives in the pharmacologic therapy of cardiac arrhythmias. Prog Cardiovasc Dis 22: 243

    Article  Google Scholar 

  8. Nademanee K, Hendrickson, J, Cannom DS et al (1981) Control of refractory life-threatening ventricular tachyarrhythmias by amiodarone. Am Heart J 6: 759

    Article  Google Scholar 

  9. Heger JJ, Prystowsky EN, Jackman WM et al (1981) Amiodarone. Clinical efficacy and electrophysiology during long-term therapy for recurrent ventricular tachycardia or ventricular fibrillation. N Engl J Med 305: 539

    Article  PubMed  CAS  Google Scholar 

  10. Hamer AW, Finerman WB, Peter T et al (1981) Disparity between the clinical and electrophysiologic effects of amiodarone in the treatment of recurrent ventricular tachyarrhythmias. Am Heart J 102: 992

    Article  PubMed  CAS  Google Scholar 

  11. Waxman HL, Groh WC, Marchlinski FE et al (1982) Amiodarone for control of sustained ventricular tachyarrhythmia: Clinical and electrophysiologic effects in 51 patients. Am J Cardiol 50: 1066

    Article  PubMed  CAS  Google Scholar 

  12. Saksena S, Rothbart ST, Cappello G (1983) Chronic effects of amiodarone in patients with refractory ventricular tachycardia. Int J Cardiol 3: 339

    Article  PubMed  CAS  Google Scholar 

  13. Nademanee K, Singh BN, Hendrickson J et al (1983) Amiodarone in refractory life-threatening ventricular arrhythmias. Ann Intern Med 98: 577

    PubMed  CAS  Google Scholar 

  14. Haffajee CI, Love JC, Canada AT et al (1983) Clinical pharmacokinetics and efficacy of amiodarone for refractory tachyarrhythmias. Circulation 67: 1347

    Article  PubMed  CAS  Google Scholar 

  15. Morady F, Sauve MJ, Maline P et al (1983) Long-term efficacy and toxicity of high dose amiodarone therapy for ventricular tachycardia or ventricular fibrillation. Am J Cardiol 52: 975

    Article  PubMed  CAS  Google Scholar 

  16. Greene HL, Graham EL, Werner JA et al (1983) Toxic and therapeutic effects of amiodarone in the treatment of cardiac arrhythmias. J Am Coll Cardiol 2: 1114

    Article  PubMed  CAS  Google Scholar 

  17. McGovern B, Garan H, Malacoff RF et al (1984) Long-term clinical outcome of ventricular tachycardia or fibrillation treated with amiodarone. Am J Cardiol 53: 1558

    Article  PubMed  CAS  Google Scholar 

  18. Marchlinski FE, Buxton AE, Flores BT et al (1985) Value of Holter monitoring in identifying risk for sustained ventricular arrhythmia recurrence on amiodarone. Am J Cardiol 55: 709

    Article  PubMed  CAS  Google Scholar 

  19. Horowitz LN, Greenspan AM, Spielman SR et al (1985) Usefulness of electrophysiologic testing in evaluation of amiodarone therapy for sustained ventricular tachyarrhythmias associated with coronary heart disease. Am J Cardiol 55: 367

    Article  PubMed  CAS  Google Scholar 

  20. Reddy CP, Kuo CS, Jivraijka V (1984) Effect of amiodarone on electric induction, morphology, and rate of ventricular tachycardia and its relation to clinical efficacy. PACE 7: 1055

    PubMed  CAS  Google Scholar 

  21. Veltri EP, Reid PR, Platia EV et al (1985) Results of late programmed electrical stimulation and long-term electrophysiologic effects of amiodarone therapy in patients with refractory ventricular tachycardia. Am J Cardiol 55: 375

    Article  PubMed  CAS  Google Scholar 

  22. Veltri EP, Reid PR, Platia EV et al (1985) Amiodarone in the treatment of life-threatening ventricular tachycardia: Role of Holter monitoring in predicting long-term clinical efficacy. J Am Coll Cardiol 6: 806

    Article  PubMed  CAS  Google Scholar 

  23. Naccarelli GV, Fineberg NA, Zipes DP et al (1985) Amiodarone: Risk factors for recurrence of symptomatic ventricular tachycardia identified at electrophysiologic study. J Am Coll Cardiol 6: 814

    Article  PubMed  CAS  Google Scholar 

  24. Morady F, Scheinman MM, Hess DS (1983) Amiodarone in the management of patients with ventricular tachycardia and ventricular fibrillation. PACE 6: 609

    PubMed  CAS  Google Scholar 

  25. Sokoloff NN, Spielman SR, Greenspan AM et al (1986) Utility of ambulatory electrocardiographic monitoring for predicting recurrence of sustained ventricular tachyarrhythmias in patients receiving amiodarone. J Am Coll Cardiol 7: 938

    Article  PubMed  CAS  Google Scholar 

  26. DiCarlo LA Jr, Morady F, Sauve MJ et al (1985) Cardiac arrest and sudden death in patients treated with amiodarone for sustained ventricular tachycardia or ventricular fibrillation: Risk stratification based on clinical variables. Am J Cardiol 55: 372

    Article  PubMed  Google Scholar 

  27. Borggrefe M, Breithardt G (1986) Predictive value of electrophysiologic testing in the treatment of drug- refractory ventricular arrhythmias with amiodarone. European Heart J 7: 735–742

    CAS  Google Scholar 

  28. Alboni P, Shantha N, Pirani R, Baggioni F, Scarfo’ S, Tomasi AM, Masoni A (1984) Effects of amiodarone on supraventricular tachycardia involving bypass tracts. Am J Cardiol 53: 93–98

    Article  PubMed  CAS  Google Scholar 

  29. Feld GK, Nademanee K, Weiss J, Stevenson W, Singh BN (1984) Electrophysiologic basis for the suppression by amiodarone of orthodromic supraventricular tachycardias complicating pre-excitation syndromes. J Am Coll Cardiol 3: 1298–1307

    Article  PubMed  CAS  Google Scholar 

  30. Rowland E, Krikler D (1980) Electrophysiological assessment of amiodarone in treatment of resistant supraventricular arrhythmias. Br Heart J 44: 82–90

    Article  PubMed  CAS  Google Scholar 

  31. Wellens HJJ, Brugada P, Abdullah H (1983) Effect of amiodarone in paroxysmal supraventricular tachycardia with or without Wolff-Parkinson-White syndrom. Am Heart J 106: 876–879

    Article  PubMed  CAS  Google Scholar 

  32. Brugada P, Wellens HJJ (1985) Effects of oral amiodarone on rate-dependent changes in refractoriness in patients with Wolff-Parkinson-White syndrome. Am J Cardiol 56: 863–866

    Article  PubMed  CAS  Google Scholar 

  33. Harris L, McKenna WJ, Rowland E, Holt DW, Storey GCA, Krikler DM (1983) Side effects of long-term amiodarone therapy. Circulation 67: 45–51

    Article  PubMed  CAS  Google Scholar 

  34. Raeder EA, Podrid PJ, Lown B (1985) Side effects and complications of amiodarone therapy. Am Heart J 109: 975

    Article  PubMed  CAS  Google Scholar 

  35. Lavery D, Saksena S, Gordon S et al (1986) Long-term efficacy of amiodarone therapy in refractory sustained ventricular tachycardia: The role of electrophysiologic studies and ambulatory monitoring. J Am Coll Cardiol 7: 91A (Abstr)

    Article  Google Scholar 

  36. Kennedy EE, Batsford WP, Rosenfled LE et al (1984) Predicting therapeutic efficacy with amiodarone: a combined Holter/electrophysiologic approach. J Am Coll Cardiol 3: 605

    Google Scholar 

  37. Chua W, Roth H, Summers C et al (1983) Programmed stimulation versus ambulatory monitoring for therapy of malignant arrhythmias. Circulation 68: III–55

    Google Scholar 

  38. Kim SG, Felder SD, Figeura I et al (1986) Predictive accuracies of Holter monitoring and programmed stimulation in patients taking amiodarone. J Am Coll Cardiol 7: 143 A (Abstr)

    Article  Google Scholar 

  39. Stamato NJ, Marchlinski FE (1986) Role of Holter monitoring in the management of patients with ventricular tachycardia treated with amiodarone. Clin Prog Electrophysiol Pacing 4: 395–401

    Google Scholar 

  40. Denes P, Wu D, Dhingra RC, Amat-y-Leon F, Wyndham C, Mautrer RK, Rosen KM (1976) Electrophysiolical studies in patients with chronic recurrent ventricular tachycardia. Circulation 54: 229–236

    PubMed  CAS  Google Scholar 

  41. Josephson ME, Horowitz LN, Farshidi A, Kastor JA (1978) Recurrent sustained ventricular tachycardia. 1. Mechanismus. Circulation 57: 431–440

    PubMed  CAS  Google Scholar 

  42. Fisher JD, Cohen HL, Mehra R, Altschuler H, Eschwer DJW, Furman S (1977) Cardiac pacing and pacemakers. II. Serial electrophysiologic-pharmacologic testing for control of recurrent tachyarrhythmias. Am Heart J 93: 658–668

    Article  PubMed  CAS  Google Scholar 

  43. Hartzler GO, Maloney JD (1977) Programmed ventricular stimulation in management of recurrent ventricular tachycardia. Mayo Clin Proc 52: 731–741

    PubMed  CAS  Google Scholar 

  44. Wu D, Wyndham CR, Denes P, Amat-y-Leon F, Miller RH, Dhingra RC, Rosen KM (1977) Chronic electrophysiological study in patients with recurrent paroxysmal tachycardia: a new method for developing successful oral antiarrhythmic therapy. In: Kulbertus HE (Ed) (1977) Re-entrant arrhythmias. Mechanisms and treatment. MTP Lancaster, 294–311

    Google Scholar 

  45. Horowitz LN, Josephson ME, Farshidi A, Spielman SR, Michelson EL, Greenspan AN (1978) Recurrent sustained ventricular tachycardia. 3. Role of the electrophysiologic study in selection of antiarrhythmic regimens. Circulation 58: 986–997

    PubMed  CAS  Google Scholar 

  46. Mason JW, Winkle RA (1978) Electrode catheter arrhythmia induction in the selection and assessment of antiarrhythmic drug therapy for recurrent ventricular tachycardia. Circulation 58: 971–985

    PubMed  CAS  Google Scholar 

  47. Breithardt G, Seipel L, Abendroth R-R, Loogen F (1980) Serial electrophysiological testing of antiarrhythmic drug efficacy in patients with recurrent ventricular tachycardia. Europ Heart J 1: 11–24

    CAS  Google Scholar 

  48. Denes P, Wu D, Wyndham C, Dhingra R, Bauernfeind RA, Swiryn S, Rosen KM (1980) Chronic long-term electrophysiologic study of paroxysmal ventricular tachycardia. Chest 77: 478–487

    Article  PubMed  CAS  Google Scholar 

  49. Horowitz LN, Josephson ME, Kastor J A (1980) Intracardiac electrophysiologic studies as a method for the optimization of drug therapy in chronic ventricular arrhythmia. Prog Cardiovasc Dis 23: 81–98

    Article  PubMed  CAS  Google Scholar 

  50. Mason J, Winkle RA (1980) Accuracy of the ventricular tachycardia-induction study for predicting long-term efficacy of antiarrhythmic drugs. N Engl J Med 303: 1073–1077

    Article  PubMed  CAS  Google Scholar 

  51. Swerdlow CH, Winkle RA, Mason JA (1983) Determinants of survival in patients with ventricular tachyarrhythmias. N Engl J Med 308: 1436–1442

    Article  PubMed  CAS  Google Scholar 

  52. Borggrefe M, Breithardt G (1986) Abgestufte Kriterien zur Beurteilung der Effektivität einer antiarrhythmi- schen Therapie bei Patienten mit ventrikulären Tachyarrhythmien mittels serieller elektrophysiologischer Testung. Z Kardiol 75: 70–79

    PubMed  CAS  Google Scholar 

  53. Wyndham CR, Krafchek J, Nielsen A, Hargis J, Velasco CE, Magro S (1985) Improved prediction of outcome by serial electrophysiologic tests on amiodarone. Circulation 72 suppl-III: 273 (Abstract)

    Google Scholar 

  54. Borggrefe M, Podczeck A, Breithardt G (1986) Usefulness of early versus late electrophysiologic testing in patients with ventricular tachyarrhythmias treated with amiodarone. Circulation 74 suppl-II: 223 (Abstract)

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1987 Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt

About this paper

Cite this paper

Borggrefe, M., Podczeck, A., Breithardt, G. (1987). Klinisch-elektrophysiologische Effekte von Amiodaron bei bedrohlichen ventrikulären Tachyarrhythmien. In: Steinbeck, G. (eds) Lebensbedrohliche ventrikuläre Herzrhythmusstörungen. Steinkopff. https://doi.org/10.1007/978-3-642-72405-3_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-72405-3_18

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-642-72406-0

  • Online ISBN: 978-3-642-72405-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics