A fast-acting drug delivered as a nasal spray may soon allow cardiac arrhythmia patients to self-treat at home as soon as symptoms appear.
The standard treatment during an arrhythmia episode is to slow the heart rate by performing physical actions called vagal maneuvers, one of which is performed, for example, by the Valsalva maneuver, which involves inhaling and then exhaling forcefully, in while the mouth and nose are covered or held closed for up to 10 seconds.
If self-administered maneuvers are not effective (which happens in about 20-40% of cases), the person should immediately seek treatment with intravenous drugs in an emergency room to return the heart rhythm to normal.
“We are talking about a potential and exciting new option for patients to safely self-treat their fast heartbeats without direct medical supervision to avoid emergency room visits and medical interventions,” said James E. Ip , MD, lead study author and associate professor of clinical medicine at Weill Cornell Medicine at New York-Presbyterian Hospital.
About one in 300 Americans experience cardiac arrhythmia, intermittent periods of rapid heartbeats (more than 100 beats per minute and more commonly 150 to 200 beats per minute) in the heart’s lower chambers, a condition called paroxysmal supraventricular tachycardia.
In a previous study, people with the disorder were treated with either the drug in the form of an experimental etripamil nasal spray or a placebo nasal spray for a single episode of arrhythmia.
Participants applied an electrocardiogram (ECG) patch at the onset of symptoms, performed a vagal maneuver and self-administered the nasal spray if the rapid heartbeat continued – keeping the ECG patch on for at least five hours.
In the study, the first in which the experimental nasal spray was used without direct supervision, normal heart rhythms were restored within 30 minutes in 54% of patients, and the drug was found to be safe and well tolerated.
Subsequently, in the present research, patients with an average age of 58 years were asked to self-medicate with the experimental nasal spray during multiple episodes of paroxysmal supraventricular tachycardia (PSVT).
Of the 169 patients enrolled, 105 self-administered at least one dose of etripamil (70 mg) during the mean study period of 232 days, and the results, published in Journal of the American Heart Associationare promising.
The study authors observed that the experimental nasal spray returned the heart rate to normal within 30 minutes in 60.2% of the 188 PSVT episodes tested, and within an hour in 75.1% of the episodes.
As for side effects, they occurred in 32.4% of cases and were mild to moderate nasal congestion, nasal discomfort or runny nose.
“There are no great options for patients to self-treat paroxysmal supraventricular tachycardia, and this condition can cause significant distress and anxiety,” explained the study’s author.
Similar to an albuterol inhaler for asthma patients or an epinephrine pen for patients who have severe allergies or anaphylaxis, the experimental etripamil nasal spray could be an excellent option for people who have paroxysmal supraventricular tachycardia, he says.
2023-10-25 21:04:00
#Nasal #spray #cardiac #arrhythmia #successfully #tested
