Summary
It is now recognized that ventricular and supraventricular arrhythmias are serious complications of congestive heart failure. There are four possible drug-related mechanisms: diuretic-induced electrolyte imbalance; digitalis-induced arrhythmias; use of sympathomimetic agents; and drug interactions with digoxin. In selecting optimal therapy for congestive heart failure all these drug interactions need to be borne in mind.
References
Papademetriou V. Diuretics, hypokalemia, and cardiac arrhythmias. A critical analysis.Am Heart J 1986;111:1217–24.
Helfant RH. Hypokalemia and arrhythmias.Am J Med 1986;80(Suppl 4A):13–22.
Stewart DE, Ikram H, Espiner A, et al. Arrhythmogenic potential of diuretic-induced hypokalemia in patients with mild hypertension and ischemic heart disease.Br Heart J 1985;54:290–97.
Nordrehaug JE, von der Lippe G. Hypokalaemia and ventricular fibrillation in acute myocardial infarction.Br Heart J 1983;50:525–29.
Lim P, Jacob E. Magnesium deficiency in patients on long-term diuretic therapy for heart failure.Br Med J 1972;3:620–22.
Sheehan J, White A. Diuretic-associated hypomagnesemia.Br Med J 1982;285:1157–59.
Seller RH, Cangiano J, Kim KE, et al. Digitalis toxicity and hypomagnesemia.Am Heart J 1970;79:57–68.
DeCarli C, Sprouse G, LaRosa JC. Serum magnesium levels in symptomatic atrial fibrillation and their relation to rhythm control by intravenous digoxin.Am J Cardiol 1986;57:956–59.
Shapiro W. Correlative studies of serum digitalis levels and the arrhythmias of digitalis intoxication.Am J Cardiol 1978;41:852–59.
Ewy GA, Marcus FI, Fillmore SJ, et al. In: Mélmon KL, ed.Cardiovascular Drug Therapy. Philadelphia: Davis Co, 1974:153–72.
Cleland JGF, Dargie HJ, Pettigrew A, et al. The effects of captopril on serum digoxin and urinary urea and digoxin clearances in patients with congestive heart failure.lAm Heart J 1986;112:130–35.
Waldorff S, Andersen JD, Heeboll-Nielsen N, et al. Spironolactone-induced changes in digoxin kinetics.Clin Pharmacol Ther 1978;24:162–67.
Waldorff S, Hansen PB, Kjaergard H, et al. Amiloride-induced changes in digoxin dynamics and kinetics: Abolition of digoxin-induced inotropism with amiloride.Clin Pharmacol Ther 1981;30:172–76.
Waldorff S, Hansen PB, Egeblad H, et al. Interactions between digoxin and potassium-sparing diuretics.Clin Pharmacol Ther 1983;33:418–23.
Marcus FI. Pharmacokinetic interactions between digoxin and other drugs.J Am Coll Cardiol 1985;5:82A-90A.
Fenster PE, Hager WD, Goodman MM. Digoxin-quinidine-spironolactone interaction.Clin Pharmacol Ther 1984;36:70–73.
Plunkett LM, Gokhale RD, Vallner JJ, et al. Prazosin alters free and total plasma digoxin levels in dogs.Am Heart J 1985;109:847–51.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Opie, L.H. Drug-related arrhythmias during therapy of congestive heart failure. Cardiovasc Drug Ther 1, 195–198 (1987). https://doi.org/10.1007/BF02125474
Issue Date:
DOI: https://doi.org/10.1007/BF02125474