Document Detail

Combination therapy with mexiletine and sotalol suppresses inherited ventricular arrhythmias in German shepherd dogs better than mexiletine or sotalol monotherapy: a randomized cross-over study.
MedLine Citation:
PMID:  20663731     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To determine the spontaneous variability of ventricular arrhythmias (VA) and evaluate anti-arrhythmic efficacy of mexiletine, sotalol, and a mexiletine-sotalol combination in German shepherd dogs (GSD) with inherited arrhythmias.
ANIMALS, MATERIALS AND METHODS: 12 affected GSD, median age 20 weeks, received mexiletine (8 mg/kg PO q8 h), sotalol (2.5 mg/kg PO q12 h), and combination therapy for 6 days in random order. Pre- and post-treatment 24 h Holter recordings were acquired, allowing determination of VA variability and reduction in 24 h VA for each treatment. Drug concentrations during each arm were measured.
RESULTS: An anti-arrhythmic effect could be inferred if ventricular premature complexes (VPC), ventricular couplets (V(cpl)), ventricular tachycardia runs (VT(runs)) and total ventricular ectopy (VE(tot)) frequency were reduced by 61%, 97%, 98%, and 63% (1 control Holter model), by 53%, 94%, 95%, and 54% (4 control Holter model) and by 54%, 95%, 96% and 56% (3 control Holter model). Combination therapy reduced VPC and VE(tot) in more dogs (5/12 and 6/12) than mexiletine (1/11 and 2/11) or sotalol (2/9 and 1/9) (p < 0.05). The combination therapy reduced the mean number of VPC, V(cpl), and VE(tot). Sotalol monotherapy produced an increase in VT(runs). Plasma mexiletine concentration was higher during combination therapy than with monotherapy.
CONCLUSIONS: Combination therapy reduced VPC in affected GSD. Sotalol monotherapy increased VT(runs). Combination therapy increased plasma mexiletine concentrations.
Anna R M Gelzer; Marc S Kraus; Mark Rishniw; Shari A Hemsley; N Sydney Moïse
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology     Volume:  12     ISSN:  1875-0834     ISO Abbreviation:  J Vet Cardiol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101163270     Medline TA:  J Vet Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  93-106     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Elsevier B.V. All rights reserved.
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
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MeSH Terms
Anti-Arrhythmia Agents / administration & dosage,  blood,  therapeutic use*
Arrhythmias, Cardiac / drug therapy,  veterinary*
Cross-Over Studies
Dog Diseases / drug therapy*
Drug Therapy, Combination / veterinary
Electrocardiography, Ambulatory / veterinary
Mexiletine / administration & dosage,  blood,  therapeutic use*
Prospective Studies
Sotalol / administration & dosage,  blood,  therapeutic use*
Tachycardia, Ventricular / drug therapy,  veterinary
Ventricular Premature Complexes / drug therapy,  veterinary
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 31828-71-4/Mexiletine; 3930-20-9/Sotalol

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