Document Detail


A perspective on the ESVEM trial current knowledge: sotalol should not be the first-line agent in the management of ventricular arrhythmias.
MedLine Citation:
PMID:  8638026     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The Electrophysiologic Study Versus Electrocardiographic Monitoring (ESVEM) trial has recently shown the superiority of sotalol over class-1 agents in lowering the rate of recurrence of ventricular tachyarrhythmias. However, this study was not placebo-controlled, and amiodarone was not included as one of the antiarrhythmic drugs in the trial. Randomized comparative trials between sotalol and amiodarone are available, but the results are inconclusive mainly because of small sample sizes. Because of the specific pharmacokinetics of amiodarone, sotalol has become the first-line agent in the management of ventricular arrhythmias. Because this policy is based on expediency rather than follow-up data, the long-term efficacy, morbidity, and safety of sotalol should be compared with those of amiodarone as well as of nonpharmacological treatment modes for ventricular tachyarrhythmias, such as implantable cardioverter defibrillator therapy in prospective trials. Until these issues are resolved, it is incorrect to say that sotalol should be the first-line agent in the management of ventricular arrhythmias.
Authors:
H Garan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Progress in cardiovascular diseases     Volume:  38     ISSN:  0033-0620     ISO Abbreviation:  Prog Cardiovasc Dis     Publication Date:    1996 May-Jun
Date Detail:
Created Date:  1996-07-11     Completed Date:  1996-07-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376442     Medline TA:  Prog Cardiovasc Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  455-6     Citation Subset:  AIM; IM    
Affiliation:
Cardiac Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Anti-Arrhythmia Agents / therapeutic use*
Clinical Trials as Topic
Humans
Sotalol / therapeutic use*
Tachycardia, Ventricular / drug therapy*
Treatment Outcome
Ventricular Fibrillation
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Anti-Arrhythmia Agents; 3930-20-9/Sotalol

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


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