Key result
Combination therapy with fludrocortisone, disopyramide, and nonpharmacologic treatment successfully managed neurogenic orthostatic hypotension and hyperkinetic arrhythmias in an elderly patient.
Why the study?
Does the combination of fludrocortisone and disopyramide improve symptoms in an elderly patient with orthostatic hypotension and hyperkinetic arrhythmias?
Case Report (n=1)
No
Does the combination of fludrocortisone and disopyramide improve symptoms in an elderly patient with orthostatic hypotension and hyperkinetic arrhythmias?
The combination of fludrocortisone and disopyramide may be an effective strategy for managing orthostatic hypotension complicated by hyperkinetic arrhythmias in elderly patients.
Answers are grounded in this paper and cite their sources.
May warrant individualized trial in refractory elderly cases; leaves open need for controlled studies to confirm safety and efficacy.
Orthostatic hypotension (OH) is a debilitating condition very common in the elderly that may leads to syncope. There is no single drug able to limit the fall in blood pressure in patients affected by OH when standing. In addition, the presence of hyperkinetic arrhythmias may worsen the fall in orthostatic blood pressure especially in elderly patients affected by OH. Unfortunately most of antiarrhythmic therapies lead to a decrease in blood pressure contrasting the effect of OH treatment. By contrast, disopyramide seems to have an anticholinergic effect that could play an important role in limiting the fall in blood pressure in participants with hyperkinetic arrhythmias and OH. We report a case of successful combination therapy of fludrocortisone, disopyramide and nonpharmacologic treatment in an elderly participant affected by neurogenic orthostatic OH and hyperkinetic arrhythmias with a poor quality of life and frequent syncope episodes.
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Langellotto et al. (2012) conducted a case report in Neurogenic orthostatic hypotension and hyperkinetic arrhythmias (n=1). Fludrocortisone, disopyramide, and nonpharmacologic treatment was evaluated. Combination therapy with fludrocortisone, disopyramide, and nonpharmacologic treatment successfully managed neurogenic orthostatic hypotension and hyperkinetic arrhythmias in an elderly patient.
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