Atrial Fibrillation in Wolff‐Parkinson‐White Syndrome: Reversal of Isoproterenol Effects by Sotalol
Identifieur interne : 000771 ( Main/Corpus ); précédent : 000770; suivant : 000772Atrial Fibrillation in Wolff‐Parkinson‐White Syndrome: Reversal of Isoproterenol Effects by Sotalol
Auteurs : A. H. Madrid ; C. Moro ; E. Marín Huerta ; L. Novo ; J. L. MestreSource :
- Pacing and Clinical Electrophysiology [ 0147-8389 ] ; 1992-11.
English descriptors
Abstract
Sotalol has Class II and III antiarrhythmic effects. Its efficacy and safety as a treatment of atrial fibrillation in patients with the Wolff‐Parkinson‐White (WPW) syndrome is controversial. We evaluated the effects of isoproterenol and IV sotalol (1.5 mg/kg in 10 minutes) given together versus isoproterenol alone on anterograde conduction through the AV node and accessory pathway. Atrial fibrillation was induced in 22 patients with WPW (13 men, 9 women, 36 ± 16 years old). AV node and accessory pathway conduction were both enhanced by isoproterenol, although the effect was greater on the AV node. The minimum interval between preexcited QRS complexes shortened in all patients. Conversely, sotalol caused a significant prolongation of the shortest preexcited QRS interval as well as of the shortest interval between narrow QRS complexes. In addition, sotalol reversed all the effects of isoproterenol during atrial fibrillation. The percent of preexcited QRS complexes was not significantly modified because variations in ventricular preexcitation results from a balance between the relative effects on refractoriness of the accessory pathway versus of the AV node and in the amount of respective anterograde and‐ retrograde concealed conduction. There were no serious adverse effects.’Reversion to sinus rhythm was documented in 12 patients (60%). These short‐term observations suggest that sotalol may be safe and effective in the treatment of patients with WPW and atrial fibrillation.
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DOI: 10.1111/j.1540-8159.1992.tb03031.x
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Madrid</name><affiliation><mods:affiliation>Arrhythmia Unit, Ramón y Cajal Hospital, Madrid, Spain</mods:affiliation></affiliation></author><author><name sortKey="Moro, C" sort="Moro, C" uniqKey="Moro C" first="C." last="Moro">C. Moro</name><affiliation><mods:affiliation>Arrhythmia Unit, Ramón y Cajal Hospital, Madrid, Spain</mods:affiliation></affiliation></author><author><name sortKey="Huerta, E Marin" sort="Huerta, E Marin" uniqKey="Huerta E" first="E. Marín" last="Huerta">E. Marín Huerta</name><affiliation><mods:affiliation>Arrhythmia Unit, Ramón y Cajal Hospital, Madrid, Spain</mods:affiliation></affiliation></author><author><name sortKey="Novo, L" sort="Novo, L" uniqKey="Novo L" first="L." last="Novo">L. Novo</name><affiliation><mods:affiliation>Arrhythmia Unit, Ramón y Cajal Hospital, Madrid, Spain</mods:affiliation></affiliation></author><author><name sortKey="Mestre, J L" sort="Mestre, J L" uniqKey="Mestre J" first="J. L." last="Mestre">J. L. Mestre</name><affiliation><mods:affiliation>Arrhythmia Unit, Ramón y Cajal Hospital, Madrid, Spain</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Pacing and Clinical Electrophysiology</title><idno type="ISSN">0147-8389</idno><idno type="eISSN">1540-8159</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1992-11">1992-11</date><biblScope unit="volume">15</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="2111">2111</biblScope><biblScope unit="page" to="2115">2115</biblScope></imprint><idno type="ISSN">0147-8389</idno></series><idno type="istex">1A4DF02195938D576EBB43B8B17311AA86A56639</idno><idno type="DOI">10.1111/j.1540-8159.1992.tb03031.x</idno><idno type="ArticleID">PACE2111</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0147-8389</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Wolff‐Parkinson‐White syndrome</term><term>atrial fibrillation</term><term>isoproterenol</term><term>sotalol</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Sotalol has Class II and III antiarrhythmic effects. Its efficacy and safety as a treatment of atrial fibrillation in patients with the Wolff‐Parkinson‐White (WPW) syndrome is controversial. We evaluated the effects of isoproterenol and IV sotalol (1.5 mg/kg in 10 minutes) given together versus isoproterenol alone on anterograde conduction through the AV node and accessory pathway. Atrial fibrillation was induced in 22 patients with WPW (13 men, 9 women, 36 ± 16 years old). AV node and accessory pathway conduction were both enhanced by isoproterenol, although the effect was greater on the AV node. The minimum interval between preexcited QRS complexes shortened in all patients. Conversely, sotalol caused a significant prolongation of the shortest preexcited QRS interval as well as of the shortest interval between narrow QRS complexes. In addition, sotalol reversed all the effects of isoproterenol during atrial fibrillation. The percent of preexcited QRS complexes was not significantly modified because variations in ventricular preexcitation results from a balance between the relative effects on refractoriness of the accessory pathway versus of the AV node and in the amount of respective anterograde and‐ retrograde concealed conduction. There were no serious adverse effects.’Reversion to sinus rhythm was documented in 12 patients (60%). These short‐term observations suggest that sotalol may be safe and effective in the treatment of patients with WPW and atrial fibrillation.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>A.H. MADRID</name><affiliations><json:string>Arrhythmia Unit, Ramón y Cajal Hospital, Madrid, Spain</json:string></affiliations></json:item><json:item><name>C. MORO</name><affiliations><json:string>Arrhythmia Unit, Ramón y Cajal Hospital, Madrid, Spain</json:string></affiliations></json:item><json:item><name>E. MARÍN HUERTA</name><affiliations><json:string>Arrhythmia Unit, Ramón y Cajal Hospital, Madrid, Spain</json:string></affiliations></json:item><json:item><name>L. NOVO</name><affiliations><json:string>Arrhythmia Unit, Ramón y Cajal Hospital, Madrid, Spain</json:string></affiliations></json:item><json:item><name>J.L. MESTRE</name><affiliations><json:string>Arrhythmia Unit, Ramón y Cajal Hospital, Madrid, Spain</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>atrial fibrillation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Wolff‐Parkinson‐White syndrome</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>sotalol</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>isoproterenol</value></json:item></subject><articleId><json:string>PACE2111</json:string></articleId><language><json:string>eng</json:string></language><abstract>Sotalol has Class II and III antiarrhythmic effects. Its efficacy and safety as a treatment of atrial fibrillation in patients with the Wolff‐Parkinson‐White (WPW) syndrome is controversial. We evaluated the effects of isoproterenol and IV sotalol (1.5 mg/kg in 10 minutes) given together versus isoproterenol alone on anterograde conduction through the AV node and accessory pathway. Atrial fibrillation was induced in 22 patients with WPW (13 men, 9 women, 36 ± 16 years old). AV node and accessory pathway conduction were both enhanced by isoproterenol, although the effect was greater on the AV node. The minimum interval between preexcited QRS complexes shortened in all patients. Conversely, sotalol caused a significant prolongation of the shortest preexcited QRS interval as well as of the shortest interval between narrow QRS complexes. In addition, sotalol reversed all the effects of isoproterenol during atrial fibrillation. The percent of preexcited QRS complexes was not significantly modified because variations in ventricular preexcitation results from a balance between the relative effects on refractoriness of the accessory pathway versus of the AV node and in the amount of respective anterograde and‐ retrograde concealed conduction. There were no serious adverse effects.’Reversion to sinus rhythm was documented in 12 patients (60%). 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The percent of preexcited QRS complexes was not significantly modified because variations in ventricular preexcitation results from a balance between the relative effects on refractoriness of the accessory pathway versus of the AV node and in the amount of respective anterograde and‐ retrograde concealed conduction. There were no serious adverse effects.’Reversion to sinus rhythm was documented in 12 patients (60%). 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Madrid, Arrhythmia Unit, Ramón y Cajal Hospital, C/Colmenar Viejo Km 9,100, 28034 Madrid, Spain.</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:PACE.PACE2111.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="referenceTotal" number="9"></count><count type="linksCrossRef" number="6"></count></countGroup><titleGroup><title type="main">Atrial Fibrillation in Wolff‐Parkinson‐White Syndrome: Reversal of Isoproterenol Effects by Sotalol</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1" corresponding="yes"><personName><givenNames>A.H.</givenNames><familyName>MADRID</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>C.</givenNames><familyName>MORO</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1"><personName><givenNames>E. MARÍN</givenNames><familyName>HUERTA</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a1"><personName><givenNames>L.</givenNames><familyName>NOVO</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a1"><personName><givenNames>J.L.</givenNames><familyName>MESTRE</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="ES"><unparsedAffiliation>Arrhythmia Unit, Ramón y Cajal Hospital, Madrid, Spain</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">atrial fibrillation</keyword><keyword xml:id="k2">Wolff‐Parkinson‐White syndrome</keyword><keyword xml:id="k3">sotalol</keyword><keyword xml:id="k4">isoproterenol</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p>Sotalol has Class II and III antiarrhythmic effects. Its efficacy and safety as a treatment of atrial fibrillation in patients with the Wolff‐Parkinson‐White (WPW) syndrome is controversial. We evaluated the effects of isoproterenol and IV sotalol (1.5 mg/kg in 10 minutes) given together versus isoproterenol alone on anterograde conduction through the AV node and accessory pathway. Atrial fibrillation was induced in 22 patients with WPW (13 men, 9 women, 36 ± 16 years old). AV node and accessory pathway conduction were both enhanced by isoproterenol, although the effect was greater on the AV node. The minimum interval between preexcited QRS complexes shortened in all patients. Conversely, sotalol caused a significant prolongation of the shortest preexcited QRS interval as well as of the shortest interval between narrow QRS complexes. In addition, sotalol reversed all the effects of isoproterenol during atrial fibrillation. The percent of preexcited QRS complexes was not significantly modified because variations in ventricular preexcitation results from a balance between the relative effects on refractoriness of the accessory pathway versus of the AV node and in the amount of respective anterograde and‐ retrograde concealed conduction. There were no serious adverse effects.’Reversion to sinus rhythm was documented in 12 patients (60%). These short‐term observations suggest that sotalol may be safe and effective in the treatment of patients with WPW and atrial fibrillation.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Atrial Fibrillation in Wolff‐Parkinson‐White Syndrome: Reversal of Isoproterenol Effects by Sotalol</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Atrial Fibrillation in Wolff‐Parkinson‐White Syndrome: Reversal of Isoproterenol Effects by Sotalol</title></titleInfo><name type="personal"><namePart type="given">A.H.</namePart><namePart type="family">MADRID</namePart><affiliation>Arrhythmia Unit, Ramón y Cajal Hospital, Madrid, Spain</affiliation><description>Correspondence: Address for reprints: Antonio H. Madrid, Arrhythmia Unit, Ramón y Cajal Hospital, C/Colmenar Viejo Km 9,100, 28034 Madrid, Spain.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.</namePart><namePart type="family">MORO</namePart><affiliation>Arrhythmia Unit, Ramón y Cajal Hospital, Madrid, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">E. 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Its efficacy and safety as a treatment of atrial fibrillation in patients with the Wolff‐Parkinson‐White (WPW) syndrome is controversial. We evaluated the effects of isoproterenol and IV sotalol (1.5 mg/kg in 10 minutes) given together versus isoproterenol alone on anterograde conduction through the AV node and accessory pathway. Atrial fibrillation was induced in 22 patients with WPW (13 men, 9 women, 36 ± 16 years old). AV node and accessory pathway conduction were both enhanced by isoproterenol, although the effect was greater on the AV node. The minimum interval between preexcited QRS complexes shortened in all patients. Conversely, sotalol caused a significant prolongation of the shortest preexcited QRS interval as well as of the shortest interval between narrow QRS complexes. In addition, sotalol reversed all the effects of isoproterenol during atrial fibrillation. The percent of preexcited QRS complexes was not significantly modified because variations in ventricular preexcitation results from a balance between the relative effects on refractoriness of the accessory pathway versus of the AV node and in the amount of respective anterograde and‐ retrograde concealed conduction. There were no serious adverse effects.’Reversion to sinus rhythm was documented in 12 patients (60%). These short‐term observations suggest that sotalol may be safe and effective in the treatment of patients with WPW and atrial fibrillation.</abstract><subject lang="en"><genre>Keywords</genre><topic>atrial fibrillation</topic><topic>Wolff‐Parkinson‐White syndrome</topic><topic>sotalol</topic><topic>isoproterenol</topic></subject><relatedItem type="host"><titleInfo><title>Pacing and Clinical Electrophysiology</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0147-8389</identifier><identifier type="eISSN">1540-8159</identifier><identifier type="DOI">10.1111/(ISSN)1540-8159</identifier><identifier type="PublisherID">PACE</identifier><part><date>1992</date><detail type="volume"><caption>vol.</caption><number>15</number></detail><detail type="issue"><caption>no.</caption><number>11</number></detail><extent unit="pages"><start>2111</start><end>2115</end><total>5</total></extent></part></relatedItem><identifier type="istex">1A4DF02195938D576EBB43B8B17311AA86A56639</identifier><identifier type="DOI">10.1111/j.1540-8159.1992.tb03031.x</identifier><identifier type="ArticleID">PACE2111</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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