Valproic acid: Does it have an antiarrhythmic action?
Abstract
Objective: The antiepileptic sodium valproate (valproic acid; VPA) is thought to possess an antiarrhythmic action. We aimed to explore whether this medication influences cardiac atrial ectopics or not. Methods: From December 1, 2009 to June 1, 2011, 80 consecutive patients who were newly diagnosed with cryptogenic generalized tonic-clonic seizures were enrolled in this prospective short-term longitudinal observational study, which was conducted at the Sulaimaniya General Teaching Hospital, Iraq. Forty patients were allocated to receive VPA and the rest (n=40) were given placebo. All patients underwent cardiac 24-hour Holter monitoring before and after one week of VPA or placebo administration. The minimum heart rate (MiHR) and maximum heart rate (MxHR) as well as the total number of atrial ectopics (TNAE) were evaluated. Results: VPA significantly reduced the MiHR, MxHR, and the TNAE. In the placebo group, the reduction in the MiHR was statistically significant while the reduction in the MxHR and the TNAE were not. However, the reduction in the target parameters in the VPA-treated group did not demonstrate a dose-dependent effect. When both groups were evaluated head-to-head for the reduction in the MiHR before and after week of therapy, there was no statistically significant difference between them. Conclusion: Sodium valproate therapy appears to be effective against atrial ectopic beats and may be used as an antiarrhythmic medication in patients who co-experience seizures and troublesome atrial ectopics.
Keywords
Kaynakça
- Scollo-Lavizzari G, Proeckl D.Sodium valproate-still a current antiepileptic agent?. Praxis 1994;83:1098
- Agrawal RP, Goswami J, Jain S, et al. Management of diabetic neuropathy by sodium valproate and glyceryl trinitrate spray: a prospective double-blind randomized placebo-controlled study. Diabetes Res Clin Pract. 2009;83:371-8.
- Spasic M, Zivkovic M, Lukic H. Prophylactic treatment of migraine with valproate. Med Biol 2003;10: 106-10.
- El-Mallakh RS, Huff MO. Mood stabilizers and ion regulation. Harv Rev Psychiatry 2001; 9: 23-32.
- Perucca E. Pharmacological and therapeutic properties of valproate: a summary after 35 years of clinical experience. CNS Drugs. 2002; 16:695-714.
- Meerson FZ, Shabunina EV, Malyshev IIu. Direct cardiotropic anti-arrhythmic effect of sodium valproate. Kardiologiia. 1988; 28:100-2.
- Meerson FZ, Gimrikh EO, Gutsol LIa, et al. The antiarrhythmic efficacy of sodium valproate. Kardiologiia. 1992; 32:19-21.
- Ding BC, Gao ZY, Wu M, et al. Comparison of effects of magnesium valproate and sodium valproate on the action potential of isolated papillary muscle from guinea pigs and dogs. J Tongji Med Univ. 1990; 10:248-52.
- McNamara JO. Drugs effective in the therapy of the epilepsies. In: Hardman JG, Limbird LE, Molinoff PB, Ruddon RW, Gilman AG (Eds.) Goodman & Gilman's The pharmacological basis of therapeutics, 9th edition. New York: McGraw-Hill. 1996; 476.
- Pousti A, Zare Jahromi A, Malihi G, et al. Effect of sodium valproate on ouabain-induced arrhythmia in isolated Guinea pig atria. Ira J Pharm Therap. 2007; 6:41Shabunina EV. [The effect of sodium valproate on the electrical stability of the heart in experimental myocardial infarct]. Patol Fiziol Eksp Ter. 1990; 23-5.
