Ventricular repolarization wave variations during the amiodarone treatment course

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Abstract

The aim of this study was to assess ventricular repolarization wave variations during the amiodarone treatment course for patients with ventricular arrhythmias and atrial fibrillation.

Sixty-nine patients with ventricular arrhythmias and 9 patients with persistent atrial fibrillation were treated with intravenous injection of a 150 mg loading dose of amiodarone, followed by 1 mg/minute for 6 hours and 0.5 mg/minute for 48 hours. After the initial 24 hours of intravenous injection, amiodarone was also administered orally at a dose of 0.2 g tid for 1 week; followed by 0.2 g bid for 1 week and 0.2 g qd for maintenance. During the procedure, the heart rate, QT, QTc, QTd, QTcd TpTe, TpTe-c, TpTe-d, TpTe/QT, and QTp were measured on days 1, 3, 7, 10, 14, 17, and 20 of amiodarone treatment.

The control rate of arrhythmias was 91.0% (71/78). The heart rate dropped significantly on the 7th day after treatment initiation and reached the minimal value on day 14. The QT interval was prolonged from day 3; TpTe was prolonged from day 7 to day 14; QTp was prolonged from day 1 to day 20. The longest QT interval (441.2 ± 33.9 ms) and TpTe (95.0 ± 18.0 ms) occurred on day 14. QTc, QTd, QTcd, TpTe-c, TpTe-d, and TpTe/QT showed no significant changes throughout the treatment.

Amiodarone lowers the heart rate, prolongs QT and QTp intervals, and transiently prolongs TpTe. However, it has no effects on QTc, QTd, QTcd, TpTe-c, TpTe-d or TpTe/QT. Amiodarone prolongs QT interval evenly, showing no effects on repolarization dispersion. TpTe/QT is a better indicator of ventricular transmural repolarization dispersion compared with TpTe.

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