Azimilide decreases recurrent ventricular tachyarrhythmias in patients with implantable cardioverter defibrillators

Abstract

Azimilide dihydrochloride may be a safe and effective drug for reducing the frequency of VT and ventricular fibrillation in patients with implanted ICDs.

Mortality in Patients After a Recent Myocardial Infarction

“…As shown in pervious studies, the occurrence of atrial fibrillation was significantly reduced in those patients assigned to treatment with azimilide. 19,26 TdP, a recognized complication of antiarrhythmic therapy, occurred more frequently among patients taking azimilide 100 mg (0.3%) than among placebo patients (0.1%) but was generally lower than in other recent studies with class III antiarrhythmic agents. A TdP rate of 3.1% in patients with a history of MI has been reported among patients taking sotalol.…”

“…16 -18 Oral azimilide doses of 75 and 125 mg have been shown to reduce the frequency of ventricular arrhythmias in a clinical study of patients with an implantable cardioverter-defibrillator. 19 Figure 1. Kaplan-Meier curve of all-cause mortality in placebo patients in high-risk group (HRV Յ20 U) and low-risk group (HRV Ͼ20 U).…”

Placebo-Controlled, Randomized Clinical Trial of Azimilide for Prevention of Ventricular Tachyarrhythmias in Patients With an Implantable Cardioverter Defibrillator

“…In a pilot study in ICD patients, its use was associated with a significant reduction in the recurrence of ventricular tachycardia (VT) or ventricular fibrillation (VF) terminated by appropriate shocks or ATP therapies. 14 Additionally, use of azimilide did not affect the defibrillation or pacing thresholds of the ICD devices. The present randomized, double blind, placebo-controlled study assessed the safety and efficacy of azimilide in reducing symptomatic tachyarrhythmia recurrences and subsequent ICD therapies in patients with ICDs.…”

Role of Antiarrhythmic Drugs: Frequent Implantable Cardioverter-Defibrillator Shocks, Risk of Proarrhythmia, and New Drug Therapy

“…The overall incidence of adverse events and rates of early discontinuation (35-36%) were similar to placebo. [24][25][26] Azimilide therapy led to a dose dependent prolongation of the QT interval, however, TdP was reported in 5 patients without any consequences 25 One patient had severe but reversible neutropenia with 75 mg of azimilide. 25 In the context of the above data, azimilide is the first drug submitted to the Food and Drug Administration for use with an ICD and is currently under review to be used for this indication.…”

“…[41][42][43][44] Azimilide has been shown to have minimal effects on the DFT or pacing thresholds in ICD patients. 24,45 Similarly, dronedarone has been shown to have no effect on defibrillation safety margin or pacing thresholds at its therapeutic dose or higher. 30,46 Antiarrhythmic drugs are usually increase the cycle length of VT, which improve hemodynamic tolerability and effectiveness of ATP in most situations.…”