101. 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.
- Author
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Gelzer, Anna R.M., Kraus, Marc S., Rishniw, Mark, Hemsley, Shari A., and Moïse, N. Sydney
- Subjects
MEXILETINE ,SHEEP dogs ,ARRHYTHMIA ,MYOCARDIAL depressants ,PHARMACODYNAMICS ,CROSSOVER trials - Abstract
Abstract: 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 (VTruns ) and total ventricular ectopy (VEtot ) 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 VEtot 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, Vcpl , and VEtot . Sotalol monotherapy produced an increase in VTruns . Plasma mexiletine concentration was higher during combination therapy than with monotherapy. Conclusions: Combination therapy reduced VPC in affected GSD. Sotalol monotherapy increased VTruns . Combination therapy increased plasma mexiletine concentrations. [ABSTRACT FROM AUTHOR]- Published
- 2010
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