Key result
In a canine model, sotalol combined with quinidine significantly reduced the incidence of torsades de pointes during the first hour compared to sotalol alone (1/7 vs 6/7 dogs, P<0.05).
Why the study?
Does the combination of sotalol and quinidine increase proarrhythmic events compared to sotalol alone in a canine model of acquired long QT syndrome?
Population
7 hypokalemic dogs with chronic AV block and a demand pacemaker implanted and set at a rate of 25 beats/min
Comparison
Sotalol for 2 hours combined with quinidine… vs Sotalol for 2 hours combined with saline…
Design
Preclinical, randomized cross-over protocol
Follow-up
2 hours
Authors
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Challenges expected additive proarrhythmia of Class IA+III agents in this model; leaves open human relevance and need for further study.
Does the combination of sotalol and quinidine increase proarrhythmic events compared to sotalol alone in a canine model of acquired long QT syndrome?
Absolute Event Rate: 14.3% vs 85.7%
p-value: p=< 0.05
In a canine model of long QT syndrome, combining sotalol with quinidine was not more arrhythmogenic than sotalol alone, challenging the theoretical additive proarrhythmic effect of Class IA and III drugs.
Chézalviel-Guilbert et al. (1998) studied Acquired long QT syndrome (n=7). Sotalol plus quinidine vs. Sotalol alone (with saline) was evaluated on Development of torsades de pointes (TdP) during the first hour of infusion (p=< 0.05). In a canine model, sotalol combined with quinidine significantly reduced the incidence of torsades de pointes during the first hour compared to sotalol alone (1/7 vs 6/7 dogs, P<0.05).
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