Effect of low oral doses of disopyramide and amiodarone on ventricular and atrial arrhythmias of chagasic patients with advanced myocardial damage

Sudden death in Chagas' disease

“…Therefore, therapeutical assays with drugs of the classes IA, IB, IC, and III were carried out [78][79][80][81][82][83][84][85][86][87] and, in almost all of them, efficacy of the antiarrhythmic drugs on ventricular arrhythmias was observed. However, as suppression of ectopic ventricular beats does not necessarily imply a reduction in mortality [88][89][90] , when we choose to routinely admi- nister antiarrhythmic drugs to chagasic patients with complex ventricular arrhythmias, we should know that it is possible to reduce the incidence of sudden death with the prophylactic treatment.…”

Amiodarone for arrhythmia in patients with Chagas disease: A systematic review and individual patient data meta-analysis

“…Nine studies [ 26 – 34 ] from 417 records found in the database search fulfilled eligibility criteria and were included in this systematic review, providing data from 365 subjects. There were three before-after studies [ 30 , 32 , 34 ], five case series (1 of which as follow period of a cluster randomized trial) [ 26 , 27 , 29 , 31 , 33 ] and one randomized clinical trial [ 28 ]. The mean age of participants ranged across the trials from 15 to 78 years.…”

“…The mean age of participants ranged across the trials from 15 to 78 years. In 8 studies [ 26 – 33 ], amiodarone was administered orally and the dose ranged from 200 to 1200 mg, with a mean treatment time ranging from 1 day to 27 months. In 1 study [ 34 ], the dose of amiodarone was 5 mg/kg, given intravenously.…”

“…For data synthesis, only 2 studies [ 30 , 32 ] were included in the IPD meta-analysis for ventricular premature beats, ventricular tachycardia and ventricular couplets. Other studies [ 26 – 29 , 31 , 33 , 34 ] had different designs or presented the results in a non-comparable manner; therefore, these results were described narratively ( Table 2 ).…”

“…The studies not included in the meta-analysis are described in Table 2 . Five studies [ 27 , 28 , 30 – 32 ] assessed corneal microdeposits, three studies [ 30 – 32 ] reported cases of gastrointestinal events, six studies [ 27 , 30 – 34 ] reported cases of sinus bradycardia, three studies assessed dermatological events [ 27 , 28 , 32 ] and five studies assessed drug discontinuation [ 27 , 28 , 31 – 33 ].…”