Key result
Treatment with sotalol or mexiletine-atenolol significantly reduced the number of VPCs and heart rate in Boxers, whereas atenolol or procainamide were ineffective.
Why the study?
Do different antiarrhythmic protocols (sotalol, mexiletine-atenolol, atenolol, or procainamide) reduce ventricular premature complexes and syncope in Boxers with familial ventricular arrhythmias?
RCT (n=49)
Randomized
Do different antiarrhythmic protocols (sotalol, mexiletine-atenolol, atenolol, or procainamide) reduce ventricular premature complexes and syncope in Boxers with familial ventricular arrhythmias?
In Boxers with familial ventricular arrhythmias, sotalol and the combination of mexiletine and atenolol effectively reduce ventricular premature complexes and arrhythmia severity, whereas atenolol alone or procainamide are ineffective.
May inform antiarrhythmic choice in Boxers; hypothesis-generating for veterinary use and requires prospective confirmation.
OBJECTIVE: To evaluate the effect of 4 antiarrhythmic treatment protocols on number of ventricular premature complexes (VPC), severity of arrhythmia, heart rate (HR), and number of syncopal episodes in Boxers with ventricular tachyarrhythmias. DESIGN: Randomized controlled clinical trial. ANIMALS: 49 Boxers. PROCEDURE: Dogs with > 500 VPC/24 h via 24-hour ambulatory ECG (AECG) were treated with atenolol (n = 11), procainamide (11), sotalol (16), or mexiletine and atenolol (11) for 21 to 28 days. Results of pre- and posttreatment AECG were compared with regard to number of VPC/24 h; maximum, mean, and minimum HR; severity of arrhythmia; and occurrence of syncope. RESULTS: Significant differences between pre- and posttreatment number of VPC, severity of arrhythmia, HR variables, or occurrence of syncope were not observed in dogs treated with atenolol or procainamide. Significant reductions in number of VPC, severity of arrythmia, and maximum and mean HR were observed in dogs treated with mexiletine-atenolol or sotalol; occurrence of syncope was not significantly different between these 2 treatment groups. CONCLUSIONS AND CLINICAL RELEVANCE: Treatment with sotalol or mexiletine-atenolol was well tolerated and efficacious. Treatment with procainamide or atenolol was not effective.
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Meurs et al. (2002) conducted an RCT in Ventricular tachyarrhythmias (n=49). Atenolol, procainamide, sotalol, or mexiletine and atenolol was evaluated on Number of VPC/24 h, maximum, mean, and minimum HR, severity of arrhythmia, and occurrence of syncope. Treatment with sotalol or mexiletine-atenolol significantly reduced the number of VPCs and heart rate in Boxers, whereas atenolol or procainamide were ineffective.
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