Double-blind trial of lignocaine versus sotalol for acute termination of spontaneous sustained ventricular tachycardia
Summary The efficacy of antiarrhythmic drugs for terminating sustained ventricular tachycardia (VT) has been disappointing. Lignocaine is the traditional drug but it is not very effective. Sotalol, one of the most effective drugs in suppressing spontaneous or induced VT, should theoretically be usef...
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| Veröffentlicht in: | The Lancet (British edition) 1994-07, Vol.344 (8914), p.18-23 |
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| creator | Ho, D.S.W Zecchin, R.P Richards, D.A.B Uther, J.B Ross, D.L |
| description | Summary
The efficacy of antiarrhythmic drugs for terminating sustained ventricular tachycardia (VT) has been disappointing. Lignocaine is the traditional drug but it is not very effective. Sotalol, one of the most effective drugs in suppressing spontaneous or induced VT, should theoretically be useful in this setting.
We have compared lignocaine with sotalol for the acute termination of spontaneous sustained VT not causing cardiac arrest in 33 patients (26 males, 7 females, aged 21-90) whose underlying heart disease was old myocardial infarction (28), acute myocardial infarction (2), dilated cardiomyopathy (1), or idiopathic cardiomyopathy (2). Left-ventricular ejection fraction was 35% (range 18-76%). Patients were randomly allocated in a double-blind fashion to lignocaine 100 mg (n=17) or sotalol 100 mg (=16) given intravenously over 5 min. Those with persistent VT 15 min after onset of administration of the first drug were crossed over to the other drug.
Sotalol was significantly more effective than lignocaine whether analysed on an intention-to-treat basis (69% vs 18%; 95% confidence interval for absolute difference of 51% 22-80%, p=0·003) or by analysis limited to the 31 patients with subsequent electrophysiologically proven VT (69% vs 20%). 1 patient in each group required cardioversion after the first drug. Tachycardia persisted in 14 patients in the lignocaine group and 4 in the sotalol group after 15 min. Tachycardia ceased in 7 (50%) patients who crossed over to sotalol, and in 1 patient who crossed over to lignocaine. There was 1 death in each group after the first drug and 1 death after both drugs. We conclude that sotalol was superior to lignocaine for the acute termination of sustained VT. The incidence of adverse effects was similar for the two drugs.
Lancet 1994;
344: 18-23 |
| doi_str_mv | 10.1016/S0140-6736(94)91048-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_198984588</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0140673694910480</els_id><sourcerecordid>1698280</sourcerecordid><originalsourceid>FETCH-LOGICAL-c453t-d751b397b6ebf542b9748533ee4548f32a4d80b535b85e7ed75f6cc7b1bcaa013</originalsourceid><addsrcrecordid>eNqFkMFKLDEQRYMoOk_9BCG40kU_k-mkk6xERn1PEFyo4C4k6WqN9CRjkh7w7-12BreualH33KIOQieU_KWENhePhDJSNaJuzhQ7V5QwWZEdNKNMsIoz8bKLZj-RA_Qn53dCCGsI30f7QtH5XDUztL6Og-2hsr0PLS7Jmx7HDvf-NURnfAC8hpSHjHMspo897mLCxg0FcIG09MEUH8OE5FUMxQSIU3jIZYLbkQ5jqRt6k3Ax7u3TmdR6c4T2OtNnON7OQ_R8e_O0-F_dP_y7W1zdV47xulSt4NTWStgGbMfZ3CrBJK9rAMaZ7Oq5Ya0kltfcSg4CxnzXOCcstc4YQutDdLrpXaX4MUAu-j0OKYwnNVVSScalHEN8E3Ip5pyg06vklyZ9akr05Fp_u9aTSK2Y_natycidbMsHu4T2h9rKHfeXmz2MH649JJ2dh-Cg9Qlc0W30v1z4ApkekUY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>198984588</pqid></control><display><type>article</type><title>Double-blind trial of lignocaine versus sotalol for acute termination of spontaneous sustained ventricular tachycardia</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><source>ProQuest Central UK/Ireland</source><source>EBSCOhost Business Source Complete</source><creator>Ho, D.S.W ; Zecchin, R.P ; Richards, D.A.B ; Uther, J.B ; Ross, D.L</creator><creatorcontrib>Ho, D.S.W ; Zecchin, R.P ; Richards, D.A.B ; Uther, J.B ; Ross, D.L</creatorcontrib><description>Summary
The efficacy of antiarrhythmic drugs for terminating sustained ventricular tachycardia (VT) has been disappointing. Lignocaine is the traditional drug but it is not very effective. Sotalol, one of the most effective drugs in suppressing spontaneous or induced VT, should theoretically be useful in this setting.
We have compared lignocaine with sotalol for the acute termination of spontaneous sustained VT not causing cardiac arrest in 33 patients (26 males, 7 females, aged 21-90) whose underlying heart disease was old myocardial infarction (28), acute myocardial infarction (2), dilated cardiomyopathy (1), or idiopathic cardiomyopathy (2). Left-ventricular ejection fraction was 35% (range 18-76%). Patients were randomly allocated in a double-blind fashion to lignocaine 100 mg (n=17) or sotalol 100 mg (=16) given intravenously over 5 min. Those with persistent VT 15 min after onset of administration of the first drug were crossed over to the other drug.
Sotalol was significantly more effective than lignocaine whether analysed on an intention-to-treat basis (69% vs 18%; 95% confidence interval for absolute difference of 51% 22-80%, p=0·003) or by analysis limited to the 31 patients with subsequent electrophysiologically proven VT (69% vs 20%). 1 patient in each group required cardioversion after the first drug. Tachycardia persisted in 14 patients in the lignocaine group and 4 in the sotalol group after 15 min. Tachycardia ceased in 7 (50%) patients who crossed over to sotalol, and in 1 patient who crossed over to lignocaine. There was 1 death in each group after the first drug and 1 death after both drugs. We conclude that sotalol was superior to lignocaine for the acute termination of sustained VT. The incidence of adverse effects was similar for the two drugs.
Lancet 1994;
344: 18-23</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(94)91048-0</identifier><identifier>PMID: 7912296</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cardiovascular disease ; Cardiovascular diseases ; Double-Blind Method ; Drug therapy ; Female ; Humans ; Lidocaine - adverse effects ; Lidocaine - therapeutic use ; Male ; Medical research ; Middle Aged ; Myocardial infarction ; Sotalol - adverse effects ; Sotalol - therapeutic use ; Tachycardia, Ventricular - diagnosis ; Tachycardia, Ventricular - drug therapy ; Tachycardia, Ventricular - etiology</subject><ispartof>The Lancet (British edition), 1994-07, Vol.344 (8914), p.18-23</ispartof><rights>1994</rights><rights>Copyright Lancet Ltd. Jul 2, 1994</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c453t-d751b397b6ebf542b9748533ee4548f32a4d80b535b85e7ed75f6cc7b1bcaa013</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/198984588?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7912296$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ho, D.S.W</creatorcontrib><creatorcontrib>Zecchin, R.P</creatorcontrib><creatorcontrib>Richards, D.A.B</creatorcontrib><creatorcontrib>Uther, J.B</creatorcontrib><creatorcontrib>Ross, D.L</creatorcontrib><title>Double-blind trial of lignocaine versus sotalol for acute termination of spontaneous sustained ventricular tachycardia</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>Summary
The efficacy of antiarrhythmic drugs for terminating sustained ventricular tachycardia (VT) has been disappointing. Lignocaine is the traditional drug but it is not very effective. Sotalol, one of the most effective drugs in suppressing spontaneous or induced VT, should theoretically be useful in this setting.
We have compared lignocaine with sotalol for the acute termination of spontaneous sustained VT not causing cardiac arrest in 33 patients (26 males, 7 females, aged 21-90) whose underlying heart disease was old myocardial infarction (28), acute myocardial infarction (2), dilated cardiomyopathy (1), or idiopathic cardiomyopathy (2). Left-ventricular ejection fraction was 35% (range 18-76%). Patients were randomly allocated in a double-blind fashion to lignocaine 100 mg (n=17) or sotalol 100 mg (=16) given intravenously over 5 min. Those with persistent VT 15 min after onset of administration of the first drug were crossed over to the other drug.
Sotalol was significantly more effective than lignocaine whether analysed on an intention-to-treat basis (69% vs 18%; 95% confidence interval for absolute difference of 51% 22-80%, p=0·003) or by analysis limited to the 31 patients with subsequent electrophysiologically proven VT (69% vs 20%). 1 patient in each group required cardioversion after the first drug. Tachycardia persisted in 14 patients in the lignocaine group and 4 in the sotalol group after 15 min. Tachycardia ceased in 7 (50%) patients who crossed over to sotalol, and in 1 patient who crossed over to lignocaine. There was 1 death in each group after the first drug and 1 death after both drugs. We conclude that sotalol was superior to lignocaine for the acute termination of sustained VT. The incidence of adverse effects was similar for the two drugs.
Lancet 1994;
344: 18-23</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Double-Blind Method</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Lidocaine - adverse effects</subject><subject>Lidocaine - therapeutic use</subject><subject>Male</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Myocardial infarction</subject><subject>Sotalol - adverse effects</subject><subject>Sotalol - therapeutic use</subject><subject>Tachycardia, Ventricular - diagnosis</subject><subject>Tachycardia, Ventricular - drug therapy</subject><subject>Tachycardia, Ventricular - etiology</subject><issn>0140-6736</issn><issn>1474-547X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkMFKLDEQRYMoOk_9BCG40kU_k-mkk6xERn1PEFyo4C4k6WqN9CRjkh7w7-12BreualH33KIOQieU_KWENhePhDJSNaJuzhQ7V5QwWZEdNKNMsIoz8bKLZj-RA_Qn53dCCGsI30f7QtH5XDUztL6Og-2hsr0PLS7Jmx7HDvf-NURnfAC8hpSHjHMspo897mLCxg0FcIG09MEUH8OE5FUMxQSIU3jIZYLbkQ5jqRt6k3Ax7u3TmdR6c4T2OtNnON7OQ_R8e_O0-F_dP_y7W1zdV47xulSt4NTWStgGbMfZ3CrBJK9rAMaZ7Oq5Ya0kltfcSg4CxnzXOCcstc4YQutDdLrpXaX4MUAu-j0OKYwnNVVSScalHEN8E3Ip5pyg06vklyZ9akr05Fp_u9aTSK2Y_natycidbMsHu4T2h9rKHfeXmz2MH649JJ2dh-Cg9Qlc0W30v1z4ApkekUY</recordid><startdate>19940702</startdate><enddate>19940702</enddate><creator>Ho, D.S.W</creator><creator>Zecchin, R.P</creator><creator>Richards, D.A.B</creator><creator>Uther, J.B</creator><creator>Ross, D.L</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TT</scope><scope>0TZ</scope><scope>0U~</scope><scope>3V.</scope><scope>7QL</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8C2</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>KB~</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7N</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope></search><sort><creationdate>19940702</creationdate><title>Double-blind trial of lignocaine versus sotalol for acute termination of spontaneous sustained ventricular tachycardia</title><author>Ho, D.S.W ; Zecchin, R.P ; Richards, D.A.B ; Uther, J.B ; Ross, D.L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c453t-d751b397b6ebf542b9748533ee4548f32a4d80b535b85e7ed75f6cc7b1bcaa013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Double-Blind Method</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Lidocaine - adverse effects</topic><topic>Lidocaine - therapeutic use</topic><topic>Male</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Myocardial infarction</topic><topic>Sotalol - adverse effects</topic><topic>Sotalol - therapeutic use</topic><topic>Tachycardia, Ventricular - diagnosis</topic><topic>Tachycardia, Ventricular - drug therapy</topic><topic>Tachycardia, Ventricular - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ho, D.S.W</creatorcontrib><creatorcontrib>Zecchin, R.P</creatorcontrib><creatorcontrib>Richards, D.A.B</creatorcontrib><creatorcontrib>Uther, J.B</creatorcontrib><creatorcontrib>Ross, D.L</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>News PRO</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Global News & ABI/Inform Professional</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database (ProQuest)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest - 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The efficacy of antiarrhythmic drugs for terminating sustained ventricular tachycardia (VT) has been disappointing. Lignocaine is the traditional drug but it is not very effective. Sotalol, one of the most effective drugs in suppressing spontaneous or induced VT, should theoretically be useful in this setting.
We have compared lignocaine with sotalol for the acute termination of spontaneous sustained VT not causing cardiac arrest in 33 patients (26 males, 7 females, aged 21-90) whose underlying heart disease was old myocardial infarction (28), acute myocardial infarction (2), dilated cardiomyopathy (1), or idiopathic cardiomyopathy (2). Left-ventricular ejection fraction was 35% (range 18-76%). Patients were randomly allocated in a double-blind fashion to lignocaine 100 mg (n=17) or sotalol 100 mg (=16) given intravenously over 5 min. Those with persistent VT 15 min after onset of administration of the first drug were crossed over to the other drug.
Sotalol was significantly more effective than lignocaine whether analysed on an intention-to-treat basis (69% vs 18%; 95% confidence interval for absolute difference of 51% 22-80%, p=0·003) or by analysis limited to the 31 patients with subsequent electrophysiologically proven VT (69% vs 20%). 1 patient in each group required cardioversion after the first drug. Tachycardia persisted in 14 patients in the lignocaine group and 4 in the sotalol group after 15 min. Tachycardia ceased in 7 (50%) patients who crossed over to sotalol, and in 1 patient who crossed over to lignocaine. There was 1 death in each group after the first drug and 1 death after both drugs. We conclude that sotalol was superior to lignocaine for the acute termination of sustained VT. The incidence of adverse effects was similar for the two drugs.
Lancet 1994;
344: 18-23</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>7912296</pmid><doi>10.1016/S0140-6736(94)91048-0</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0140-6736 |
| ispartof | The Lancet (British edition), 1994-07, Vol.344 (8914), p.18-23 |
| issn | 0140-6736 1474-547X |
| language | eng |
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| subjects | Adult Aged Aged, 80 and over Cardiovascular disease Cardiovascular diseases Double-Blind Method Drug therapy Female Humans Lidocaine - adverse effects Lidocaine - therapeutic use Male Medical research Middle Aged Myocardial infarction Sotalol - adverse effects Sotalol - therapeutic use Tachycardia, Ventricular - diagnosis Tachycardia, Ventricular - drug therapy Tachycardia, Ventricular - etiology |
| title | Double-blind trial of lignocaine versus sotalol for acute termination of spontaneous sustained ventricular tachycardia |
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