The effects of antiarrhythmic therapy with amiloride on right ventricular (RV)and left ventricular (LV) systolic performance were studied in 22 patients with inducible sustained ventricular tachycardia, 15 male, mean age 59 ± 12 years. Amiloride was given orally 5 or 10 mg b.i.d. which resulted in a mean serum trough concentration of 52.1 ± 18.2 ng/ml. Baseline LV ejection fraction (EF)did not change during amiloride therapy (35.5 ± 15.2 vs. 36.4 ± 14.9%). RV EF, however, increased slightly but significantly during amiloride therapy(43.6 ±11.1 vs. 46.9 ± 11.5%, p < 0.01). Improvement in RV EF was seen only in patients with depressed baseline LV EF (<40%). RV and LV enddiastolic and end-systolic volumes were smaller during amiloride therapy, but the changes were not statistically significant. Similarly, amiloride did not affect exercise duration or exercise heart rate or blood pressure. At peak exercise,the effects of amiloride on measures of ventricular performance were similar to those at rest. We conclude that in patients with inducible sustained ventricular tachycardia, antiarrhythmic therapy with amiloride does not adversely affect systolic ventricular function or exercise performance regardless of baseline LV function. Amiloride improves RV systolic function in patients with baseline LV dysfunction by mechanisms which need further study.

Keywords:
Amiloride, Radionuclide ventriculogram, Left ventricular function, Right ventricular function, Ventricular tachycardia, Ejection fraction
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1992
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