International journal of cardiology
-
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
First dose hypotension after angiotensin converting enzyme inhibitor captopril and angiotensin II blocker losartan in patients with acute myocardial infarction.
First dose hypotension after the administration of an angiotensin-converting enzyme inhibitor in patients with acute myocardial infarction is one of the most important adverse events of this type of treatment. There is no information about first dose hypotension after angiotensin type 1-receptor blocker in this type of patient. ⋯ Low dose of losartan is safe for initiating therapy in patients with acute myocardial infarction within 24 h of hospital admission.
-
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Safety of oral propafenone in the conversion of recent onset atrial fibrillation to sinus rhythm: a prospective parallel placebo-controlled multicentre study.
Oral propafenone is effective in restoring sinus rhythm however the proarrhythmic effects are still unknown. The Safety Antiarrhythmic Therapy Evaluation (SATE) trial was a prospective randomized placebo-controlled multicentre study which evaluated the safety of acute oral loading dose of propafenone in patients with recent onset atrial fibrillation. Secondary end-points were to evaluate the effect of digitalis added to propafenone in ventricular rate control and the efficacy of propafenone alone or added to digitalis compared with efficacy of digitalis plus quinidine. ⋯ Propafenone in a single oral loading dose is safe and promptly effective in patients with recent onset atrial fibrillation.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Heart rate variability after acute myocardial infarction in patients treated with atenolol and metoprolol.
Heart rate variability (HRV) reflects autonomous activity that influences the heart. It has been shown that HRV is depressed during acute myocardial infarction (AMI) and that it recovers with time. Beta-blockers reduce mortality after AMI and changes in sympathico-vagal activity have been suggested to be of importance. Under certain animal experimental conditions, metoprolol has been reported to increase vagal tone more than atenolol, which could have clinical implications. The purpose of the present study was to compare the effects of atenolol and metoprolol treatments on HRV during 6 weeks after AMI and to follow the post MI changes in HRV in patients on betablockers. ⋯ There was no evidence of more increased vagal tone with metoprolol compared to atenolol as has been suggested from animal models. In patients also on chronic treatment with beta blockers, an increase of HRV was seen during the first weeks post MI.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Sympathetic inhibition with clonidine improves autonomic balance in congestive heart failure.
In this double-blind, placebo-controlled crossover study, we examined the effect of transdermal clonidine (given for 5 days) on autonomic control in 14 patients with mild to moderate congestive heart failure by heart rate variability analysis. Compared with placebo, clonidine increased the 24-h mean R-R interval from 718+/-110 to 811+/-117 ms (P<0.01), increased the S. D. of all normal RR intervals (SDNN) from 60.8+/-18.5 to 80.9+/-21.4 ms (P<0.01), the S. ⋯ Changes in heart rate variability measures after clonidine administration were positively related to changes in plasma norepinephrine level. These results indicate that suppressing the sympathetic nervous system by clonidine improves autonomic balance in patients with congestive heart failure. But whether such restoration of the autonomic control has a beneficial effect on the long-term management of these patients still needs further investigation.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparative study of efficacy and safety of low-dose diltiazem or betaxolol in combination with digoxin to control ventricular rate in chronic atrial fibrillation: randomized crossover study.
The combination therapy of low-dose diltiazem or bexatolol with digoxin can be a useful adjunct for achieving heart rate control with minimal side effects. But there has not been a study including patients with impaired left ventricular function and evaluating whether the beneficial effects of medication will be maintained during a follow-up period. ⋯ Our study suggested that (1) combination therapy of low-dose betaxolol with digoxin was more superior to low-dose diltiazem with digoxin in controlling ventricular rate and reducing rate-pressure products; (2) the effects controlling ventricular rate, reducing rate-pressure products and improving exercise capacity have been well maintained even after 7 months of medication with each combination therapy.