Document Detail


The role of the selective serotonin re-uptake inhibitor sertraline in nondepressive patients with chronic ischemic heart failure: a preliminary study.
MedLine Citation:
PMID:  20487349     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Selective serotonin re-uptake inhibitors (SSRIs) have been associated with better psychiatric status, functional capacity, and fewer arrhythmias in depressive patients with heart failure (HF). In this study, we tested the impact of sertraline (an SSRI) on patients with HF, but not clinical depression.
METHODS: We studied 62 clinically stable, nondepressive patients with ischemic HF (New York Heart Association class: I-II), and implantable cardioverter-defibrillator (ICD). Following psychiatric evaluation and quality of life (QoL) assessment, 24-hour electrocardiogram recordings including heart rate variability (HRV) and ICD interrogation were performed every 4 months for 1 year. Ventricular effective refractory period (ERP) at 600-, 500-, and 400-ms cycle length and the inducibility of ventricular tachycardia (VT) were assessed via the ICD. After that, sertraline 50 mg/day was administered for 12 months and the whole evaluation was repeated.
RESULTS: Sertraline was associated with fewer ventricular extrasystoles per 24 hours and a significant change in HRV (increase in mean R-R, 5-minute standard deviation of RR intervals, and root mean-square difference of successive RR intervals, and reduction in ultra and very low frequency). It was also followed by an improvement in patients' QoL. A trend toward a decrease was observed in the number of recalled nonsustained VTs. The episodes of sustained VT were not significantly reduced. Ventricular ERPs and VT inducibility remained unaltered.
CONCLUSION: In clinically stable, nondepressive patients with ischemic HF and ICD, sertraline is associated with reduced ventricular extrasystoles, better QoL, and a possible improvement in some HRV indexes. This suggests that SSRIs may have a favorable clinical impact on these patients, independent of the improvement in depressive symptoms.
Authors:
Dionyssios Leftheriotis; Panayota Flevari; Ignatios Ikonomidis; Athanasios Douzenis; Chrisovalandis Liapis; Ioannis Paraskevaidis; Efstathios Iliodromitis; Lefteris Lykouras; Dimitrios Th Kremastinos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  33     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-30     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1217-23     Citation Subset:  IM    
Copyright Information:
©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.
Affiliation:
Department of Cardiology Department of Psychiatry, Attikon University Hospital of Athens, 1 Riministr., Haidari, Athens, Greece. dleftheriotis@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Antidepressive Agents / therapeutic use*
Chronic Disease
Defibrillators, Implantable
Depression / psychology
Female
Heart Failure / drug therapy*,  etiology*,  psychology
Heart Rate / drug effects
Humans
Male
Middle Aged
Myocardial Infarction / complications*
Quality of Life
Refractory Period, Electrophysiological / drug effects
Serotonin Uptake Inhibitors / therapeutic use*
Sertraline / therapeutic use*
Tachycardia, Ventricular / drug therapy
Treatment Outcome
Ventricular Premature Complexes / drug therapy
Chemical
Reg. No./Substance:
0/Antidepressive Agents; 0/Serotonin Uptake Inhibitors; 79617-96-2/Sertraline

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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