ABSTRACT
There are no controlled clinical trials evaluating drug therapy in patients with ventricular arrhythmias and chronic chagasic cardiomyopathy. Empirical treatment with disopyramide (400-1,000 mg/d), phenytoin (4-6 mg/d), mexiletine (600-1,200 mg/d), propafenone (900 mg/d), amiodarone (loading: 1,000 mg/d, 10-14 days; maintenance 200-600 mg/d), and sotalol (320 mg/d) had efficacy and tolerance ranging from 18 percent to 90 percent with heterogeneous criteria for efficacy definition. Further studies with homogenous criteria are required to determine which is the most appropriate drug therapy for patients with chronic chagasic cardiomyopathy and ventricular arrhythmias.
Subject(s)
Humans , Arrhythmias, Cardiac/drug therapy , Anti-Arrhythmia Agents/therapeutic use , Chagas Cardiomyopathy/drug therapy , Tachycardia, Ventricular/drug therapy , Anti-Arrhythmia Agents/administration & dosage , Chronic Disease , PrognosisABSTRACT
Apesar da grande importância da cardiopatia chagásica em nosso meio, näo existem estudos clínicos controlados que avaliem adequadamente as opçöes terapêuticas nessa doença. Foram testadas disopiramida (400=1.000 mg/dia), difenil-hidantoína (4-6 mg/Kg/dia), mexiletine (600-1.200 mg/dia), propafenona (900 mg/dia),amiodarona (impregnaçäo: 1.000 mg/dia, 10-14 dias; manutençäo: 200-600 mg/dia) e sotabol (320 mg/dia) com níveis de eficácia e tolerância variando de 18Por cento a 90 por cento, dependendo das definiçöes empregadas. Estudos comparativos controlados poderäo esclarecer futuramente as melhores estratégias farmacológicas para o tratamento dessa entidade nosológica.