International journal of cardiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative study of efficacy and safety of low-dose diltiazem or betaxolol in combination with digoxin to control ventricular rate in chronic atrial fibrillation: randomized crossover study.
The combination therapy of low-dose diltiazem or bexatolol with digoxin can be a useful adjunct for achieving heart rate control with minimal side effects. But there has not been a study including patients with impaired left ventricular function and evaluating whether the beneficial effects of medication will be maintained during a follow-up period. ⋯ Our study suggested that (1) combination therapy of low-dose betaxolol with digoxin was more superior to low-dose diltiazem with digoxin in controlling ventricular rate and reducing rate-pressure products; (2) the effects controlling ventricular rate, reducing rate-pressure products and improving exercise capacity have been well maintained even after 7 months of medication with each combination therapy.
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Case Reports
QT prolongation and polymorphous ventricular tachycardia associated with trasodone-amiodarone combination.
Trasodone, a second generation antidepressant, has been shown to equal standard tricyclics in clinical efficacy while causing significantly fewer cardiac side effects. Although clinical trials have demonstrated a relatively safe arrhythmogenic profile, trasodone has been implicated in the pathogenesis of ventricular arrhythmias. This report describes a patient in whom the administration of trasodone in addition to previously well-tolerated long-term amiodarone therapy was associated with a marked prolongation of the QT interval and polymorphous ventricular tachycardia. Caution in the concurrent use of trasodone and other medications known to cause QT prolongation and polymorphous ventricular tachycardia is recommended.