Pharmacologic treatment of supraventricular tachycardia: The German experience

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Abstract

Tachyarrhythmias that originate above the bifurcation of the bundle of His or in tissue proximal to it are classified as supraventricular tachyarrhythmias (SVTs). Primary treatment of SVT tries to influence the underlying disease. Symptomatic therapy is subdivided into drug therapy, electrotherapeutic tools (e.g., antitachycardia pacemakers, catheter ablation), and antiarrhythmic surgery. Antiarrhythmic agents that slow conduction and suppress premature beats are efficient for emergency and long-term treatment of SVTs. We evaluated some of the most relevant antiarrhythmic drugs in SVT, including propafenone, diprafenone, cibenzoline, sotalol, and dittiazem; in addition, usage and efficacy of quinidine/verapamil, disopyramide, amiodarone, ajmaline, adenosine, and flecainide are summarized.

In 1990, the case load of supraventricular arrhythmias per physician in Germany was more than 30 patients seen per month. About 50% of them were treated with drug therapy; i.e., approximately 17 patients were treated with antiarrhythmic drugs per month per physician for supraventricular arrhythmias. The most important antiarrhythmic agents used in Germany are propafenone (40%), combination of quinidine and verapamil (23%), sotalol (12%), disopyramide (6%), flecainide (6%), and other (13%).

References (61)

  • LN Horowitz et al.

    Use of amiodarone in the treatment of persistant and paroxysmal atrial fibrillation resistant to quinidine therapy

    J Am Coll Cardiol

    (1985)
  • RL Gold et al.

    Amiodarone for refractory atrial fibrillation

    Am J Cardiol

    (1986)
  • ND Mostow et al.

    Rapid control of refractory atrial tachyarrhythmias with high-dose oral amiodarone

    Am Heart J

    (1990)
  • WD Bussmann et al.

    Orally administered prajmalium bitartrate in acute and chronic ventricular arrhythmias

    Am J Cardiol

    (1978)
  • S Sclarovsky et al.

    Paroxysmal atrial flutter and fibrillation associated with pre-excitation syndrome: treatment with ajmaline

    Am J Cardiol

    (1981)
  • ELC Pritchett et al.

    Flecainide acetate treatment of paroxysmal supraventricular tachycardia and paroxysmal atrial fibrillation: dose-response studies

    J Am Coll Cardiol

    (1991)
  • KD Donovan et al.

    Reversion of recent-onset atrial fibrillation to sinus rhythm by intravenous flecainide

    Am J Cardiol

    (1991)
  • SS Kim et al.

    Treatment of paroxysmal reentrant supraventricular tachycardia with flecainide acetate

    Am J Cardiol

    (1986)
  • LM van Wijk et al.

    Flecainide acetate in the treatment of supraventricular tachycardias: Value of programmed electrical stimulation for long-term prognosis

    Am Heart J

    (1989)
  • EM Vaughan Williams

    Classification of antiarrhythmic drugs

  • M Manz et al.

    Electrophysiologic effects of diprafenone in supraventricular and ventricular tachycardia

    Z Kardiol

    (1986)
  • H Heuer et al.

    Use of diprafenone in chronic ventricular arrhythmias—results of long-term treatment

    Z Kardiol

    (1987)
  • A Geibel et al.

    Diprafenone a comparative study of antiarrhythmic therapy with propafenone

    Z Kardiol

    (1988)
  • SE Coplen et al.

    Efficacy and safety of quinidine therapy for maintenance of sinus rhythm after cardioversion. A meta-analysis of randomized control trials

    Circulation

    (1990)
  • H Gülker et al.

    Kombinierte Behandlung chronischer Vorhofrhythmusstörungen mit Chinidin—Verapamil

    Med Klin

    (1980)
  • F Bender et al.

    Behandlung tachykarder Rhythmusstörungen des Herzens durch Beta-Rezeptorenblockade des Atrioventrikulargewebes

    Med Welt

    (1966)
  • AL Wit et al.

    The effects of verapamil on the sinoatrial and atrioventricular nodes of the rabbit and the mechanism by which it arrests reentrant AV nodal tachycardia

    Circ Res

    (1974)
  • M Schlepper et al.

    The pharmacodynamics of orally taken verapamil and verapamil retard as judged by their negative dromotropic effects

    Arzneimittelforsch (Drug Res)

    (1975)
  • HL Waxman et al.

    Verapamil for control of ventricular rate in paroxysmal supraventricular tachycardia and atrial fibrillation on flutter

    Ann Intern Med

    (1981)
  • RC Rinkenberger et al.

    Effects of intravenous and chronic oral verapamil administration in patients with supraventricular tachyarrhythmias

    Circulation

    (1980)
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