Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT

Julian, D G; Camm, A. John; Frangin, G.; Mj, Janse; Muñoz, Alvaro; Schwartz, Peter J.; Simon, Patrick

doi:10.1016/s0140-6736(96)09145-3

Cited by 1,006 publications

(437 citation statements)

References 40 publications

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“…Our study is concordant with previous studies showing that treatment with mexiletine is safe and sufficiently tolerated [8][9][10][11]. The percentage of patients with mexiletine intolerance was low (18%).…”

Section: Discussionsupporting

confidence: 92%

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Efficacy and tolerability of mexiletine treatment in patients with recurrent ventricular tachyarrhythmias and implantable cardioverter-defibrillator shocks

Sobiech¹,

Lewandowski²,

Zając³

et al. 2017

Kardiol Pol

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A b s t r a c tBackground: Antiarrhythmic treatment of patients with recurrent ventricular tachyarrhythmia, in whom catheter ablation and amiodarone treatment were ineffective or contraindicated, is an unsolved clinical problem. Aim:The study aims to evaluate the efficacy and tolerability of mexiletine in patients with recurrent ventricular tachyarrhythmias and/or electrical storm events, in whom standard treatment strategies failed to prevent ventricular tachyarrhythmia. Methods:We performed a retrospective cohort analysis of all patients treated with mexiletine for recurrent ventricular tachycardia and/or ventricular fibrillation in our institution between January 2011 and September 2015. The primary endpoints were total number of electrical storm events and ventricular tachycardia/ventricular fibrillation (VT/VF) episodes after the beginning of mexiletine therapy. Secondary endpoints were total number of implantable cardioverter-defibrillator (ICD) therapies and discontinuation of the therapy. Events were compared with a matched duration period before initiating mexiletine. Patients served as self-controls.Results: Seventeen patients were included in the study; 11 patients were males. Mean age was 64.2 ± 15.4 years. The median time of mexiletine treatment was eight months (interquartile range [IR]: 1-22 months). The mexiletine dose was 600 mg/day in 13 patients and 400 mg/day in four patients. In four patients the dose was modified during treatment in a range from 400 to 600 mg/day depending on clinical decision. Treatment with mexiletine significantly reduced the number of electrical storm events (14 episodes Conclusions:Mexiletine was a sufficiently tolerated antiarrhythmic drug in short-term treatment of ventricular tachyarrhythmias in the studied population. Mexiletine may be effective in the treatment of recurring ventricular tachyarrhythmias or electrical storm events.

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Section: Discussionsupporting

confidence: 92%

“…Almost 40% of patients treated with amiodarone discontinue medication in median follow-up of 21 months. The most common causes of discontinuation are thyroid abnormalities, followed by pulmonary and gastrointestinal disorders [8].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and tolerability of mexiletine treatment in patients with recurrent ventricular tachyarrhythmias and implantable cardioverter-defibrillator shocks

Sobiech¹,

Lewandowski²,

Zając³

et al. 2017

Kardiol Pol

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“…Amiodarone, an anti-arrhythmic agent with multiple different actions, has a half-life of approximately 30 days. In recent years several studies have demonstrated that it be can be safely used in patients with left ventricular dysfunction (21,22) and it has been increasingly used in patients with heart failure for control of atrial and ventricular arrhythmias. Its main bradycardic effects are mediated through its beta receptor blocking activity.…”

Section: Discussionmentioning

confidence: 99%

Relative Perioperative Bradycardia Does Not Lead to Adverse Outcomes After Cardiac Transplantation

Goldstein

Coffey

Benza

et al. 2003

American Journal of Transplantation

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Since the effects of bradycardia after cardiac transplantation are not known, we tested the hypothesis that perioperative bradycardia would lead to an increase in adverse outcomes after cardiac transplantation. We conducted a retrospective case control study with inclusion criterion of a heart rate (HR) less than 80 bpm during the 1st week after transplantation. Control patients were matched for gender, age and time since transplantation. We identified 34 patients as having perioperative bradycardia out of the 174 who underwent cardiac transplantation between 1994 and 1997. The results demonstrated no significant differences in donor ischemic times (180 vs. 183, p = 0.88), operative surgeon (p = 0.62) or pretransplant cardiac disease (p = 0.81) between groups. Bradycardic patients were more likely to be on pretransplant amiodarone (RR = 20.4, p < 0.001). Perioperative bradycardia did not lead to increases in cellular rejection (p = 0.72) or vasculopathy (p = 0.79). The patients prescribed pretransplant amiodarone (n = 14) had a trend toward delayed time to first rejection episode (31.0 vs. 15.5 days, median, p = 0.07).In conclusion, perioperative bradycardia does not increase adverse outcomes after cardiac transplantation and is associated with pretransplant use of amiodarone. Amiodarone may modify the recipients' immune response by delaying the occurrence of rejection.

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“…The administration of amiodarone neither led to a significant decrease in mortality (17,18). Only the combination of amiodarone and beta-blockers has shown some efficacy in reduction of SCD (19).…”

Section: Discussionmentioning

confidence: 99%

Case Report of the Patient with Acute Myocardial Infarction: “From Flatline to Stent Implantation”

Petrović¹,

Ilic²,

Ilić³

et al. 2017

Acta Facultatis Medicae Naissensis

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Asystole is a rare primary manifestation in the development of sudden cardiac death (SCD), and survival during cardiac arrest as the consequence of asystole is extremely low. The aim of our paper is to illustrate successful cardiopulmonary resuscitation (CPR) in patients with acute myocardial infarction (AMI) and rare and severe form of cardiac arrest -asystole. A very short time between cardiac arrest in acute myocardial infarction, which was manifested by asystole, and the adequate CPR measures that have been taken are of great importance for the survival of our patient.After successful reanimation, the diagnosis of anterior wall AMI with ST segment elevation was established. The right therapeutic strategy is certainly the early primary percutaneous coronary intervention (PPCI). In less than two hours, after recording the "flatline" and successful reanimation, the patient was in the catheterization laboratory, where a successful PPCI of LAD was performed, after emergency coronary angiography. In the further treatment course of the patient, the majority of risk factors were corrected, except for smoking, which may be the reason for newly discovered lung tumor disease. Early recognition and properly applied treatment of CPR can produce higher rates of survival.

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Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT

Cited by 1,006 publications

References 40 publications

Efficacy and tolerability of mexiletine treatment in patients with recurrent ventricular tachyarrhythmias and implantable cardioverter-defibrillator shocks

Efficacy and tolerability of mexiletine treatment in patients with recurrent ventricular tachyarrhythmias and implantable cardioverter-defibrillator shocks

Relative Perioperative Bradycardia Does Not Lead to Adverse Outcomes After Cardiac Transplantation

Case Report of the Patient with Acute Myocardial Infarction: “From Flatline to Stent Implantation”

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