Short-term effects of varenicline therapy on homogeneity of heart rate, atrioventricular conduction and ventricular repolarization

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Smoking (n=60). Intervention: Varenicline vs. Baseline (pre-treatment). Primary outcome: PR interval (p=0.053).

Yusuf KaraveliogAAlu; Hekim Karapınar

doi:10.4172/2368-0512.1000033

January 1, 2015Current research. CardiologyOpen Access

Short-term effects of varenicline therapy on homogeneity of heart rate, atrioventricular conduction and ventricular repolarization

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Key result

Varenicline treatment in smokers resulted in a borderline significant prolongation of the PR interval (163.5 to 168.2 ms, p=0.053) but had no significant effect on heart rate, QT interval, or QT dispersion.

Why the study?

Does short-term varenicline therapy affect heart rate, atrioventricular conduction, and ventricular repolarization in adult smokers?

Key Points

To determine the short-term effects of varenicline on heart rate, atrioventricular conduction, and ventricular repolarization in smokers.
Prospectively enrolled 60 smokers receiving varenicline therapy for smoking cessation.
Obtained 12-lead electrocardiograms at baseline and on day 15 of treatment (amplitude 20 mm/mV, sweep speed 50 mm/s) to assess PR, RR, QT, and QT dispersion intervals.
Varenicline caused a slight PR interval prolongation that approached statistical significance (163.5 ± 18.3 ms vs 168.2 ± 17.9 ms; P=0.053).
No significant alterations occurred in RR interval (796.3 ± 117.4 ms vs 798.3 ± 123.7 ms; P=0.926), QT interval (384.1 ± 17.5 ms vs 383.4 ± 20.9 ms; P=0.852), or QT dispersion (52.6 ± 14.9 ms vs 52.2 ± 14.9 ms; P=0.919).
Heart rate (74.7 ± 13.3 beats/min at baseline) and resting systolic and diastolic blood pressure did not change significantly with treatment.

Study Design

Type

Observational (n=60)

Blinding

Single-blind (outcome assessors)

Multicenter

No

Structured PICO

Does short-term varenicline therapy affect heart rate, atrioventricular conduction, and ventricular repolarization in adult smokers?

P

Population

60 adult smokers without baseline cardiovascular disease or ECG abnormalities who received varenicline for smoking cessation and were evaluated at 15 days.

I

Intervention

Varenicline therapy (titrated to 1 mg twice daily: 0.5 mg once daily on days 1 to 3, and 0.5 mg twice daily on days 4 to 7) evaluated on the 15th day of drug administration.

C

Comparator

Baseline measurements before varenicline therapy (intra-individual comparison).

O

Outcome

Changes in heart rate, PR interval, QT interval, and QT dispersion (QTd) on the 15th day of drug administration.surrogate

Main Result

Absolute Event Rate: 168.2% vs 163.5%

p-value: p=0.053

Short-term varenicline therapy in healthy smokers does not significantly alter heart rate, QT interval, or QT dispersion, though it may cause a borderline prolongation of the PR interval.

Limitations

Cross-sectional design lacking evaluation of long-term effects.
Lack of ambulatory monitoring to investigate factors like heart rate variability.
Exclusion of patients at high risk for arrhythmia (e.g., heart failure, post-myocardial infarction, coronary artery disease).
Relatively small sample size.
Cross-sectional design without long-term evaluation
Lack of ambulatory monitoring to investigate other factors such as heart rate variability
Exclusion of patients at high risk for arrhythmia (e.g., heart failure, post-myocardial infarction, coronary artery disease, conduction abnormality)
Relatively small sample size

Implication

Supports repolarization safety in healthy smokers; leaves open clinical relevance of borderline PR prolongation for larger trials.

Abstract

The effects of varenicline, an effective drug for smoking cessation, on atrioventricular and ventricular conductance remain unknown. oBjeCTive: To evaluate the effects of varenicline on heart rate, PR interval, QT interval and QT dispersion (QTd). MeTHodS: A total of 60 smokers were prospectively enrolled in the present study. Twelve-lead electrocardiogram recordings were obtained for all subjects before and on the 15th day of drug administration. Electrocardiograms were recorded at an amplitude of 20 mm/mV and a sweep speed of 50 mm/s. ReSulTS: The mean ( SD) age of the volunteers was 3810 years. Thirtyfour (57%) were male. Fourteen (23%) had hypertension, eight (13%) had diabetes and six (10%) had chronic obstructive pulmonary disease. The mean heart rate was 74.713.3 beats/min, and mean systolic and diastolic blood pressures on admission were 122.314.3 mmHg and 76.510.2 mmHg, respectively. Heart rate, and systolic and diastolic blood pressures did not change with varenicline treatment. Varenicline treatment resulted in limited prolongation in PR interval, which appropached significance (163.518.3 ms versus 168.217.9 ms; P=0.053), while RR interval (796.3117.4 ms versus 798.3123.7 ms; P=0.926), QT interval (384.117.5 ms versus 383.420.9 ms; P=0.852) and QTd (52.614.9 ms versus 52.214.9 ms; P=0.919) were not significantly changed. ConCluSion: Varenicline had a limited effect on atrioventricular conduction, while it had no effect on heart rate, QT interval and QTd. Further studies are needed to prove the effects of varenicline on the conduction system of the heart, especially on PR interval.

Discussion

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Cite This Study

KaraveliogAAlu et al. (2015) conducted an observational in Smoking (n=60). Varenicline vs. Baseline (pre-treatment) was evaluated on PR interval (p=0.053). Varenicline treatment in smokers resulted in a borderline significant prolongation of the PR interval (163.5 to 168.2 ms, p=0.053) but had no significant effect on heart rate, QT interval, or QT dispersion.

synapsesocial.com/papers/6a9ebfb25c985731fbe99947 https://doi.org/10.4172/2368-0512.1000033

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Short-term effects of varenicline therapy on homogeneity of heart rate, atrioventricular conduction and ventricular repolarization

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Short-term effects of varenicline therapy on homogeneity of heart rate, atrioventricular conduction and ventricular repolarization

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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