tropisetron and Arrhythmias--Cardiac

Fibromyalgia syndrome (FMS) frequently presents with autonomic and/or functional symptoms. Tropisetron, a selective serotonin-3 antagonist, is widely used for the treatment of this disease. However, its effects on autonomic function are not well known. In the present study, we evaluated whether tropisetron improved cardiac autonomic symptoms in FMS. Thirty-six patients were treated with physiotherapy and 5 mg tropisetron intravenously for 5 days. An additional 36 patients were treated with physiotherapy alone. Thirty-six volunteers served as healthy controls. The ISAX apparatus was used for spectral analyses of cardiac R-R intervals. High frequencies and mid frequencies were analysed to assess sympathetic and parasympathetic activity. The findings were correlated with pain intensity. ISAX findings were significantly different in FMS patients compared to healthy controls and did not correlate with pain perception. Ten of 12 pathological parameters disappeared during treatment in the tropisetron group. Our results indicate that tropisetron reduced not only pain perception but also had a favourable effect on cardiac dysfunction during treatment.

Topics: Adult; Arrhythmias, Cardiac; Autonomic Nervous System; Combined Modality Therapy; Female; Fibromyalgia; Heart Rate; Humans; Indoles; Middle Aged; Pain Measurement; Physical Therapy Modalities; Serotonin Antagonists; Severity of Illness Index; Tropisetron

Topics: Adult; Antiemetics; Arrhythmias, Cardiac; Electrocardiography; Female; Gynecologic Surgical Procedures; Humans; Indoles; Injections, Intravenous; Ovarian Cysts; Postoperative Complications; Postoperative Nausea and Vomiting; Reflex; Tachycardia, Supraventricular; Tropisetron

The effects of ICS 205-930 [3 alpha-tropanyl)-1H-indole-3-carboxylic acid ester), an antagonist of 5-HT at neuronal M receptors, were examined in anaesthetised greyhounds subject to acute coronary artery occlusion and reperfusion. Intravenous administration of 0.3 or 2.0 mg kg-1 of ICS 205-930 did not significantly alter haemodynamics or blood gases. The higher dose had marked antiarrhythmic activity. The total number of ischaemia-induced extrasystoles was reduced to 167 +/- 64 compared with 467 +/- 99 in controls. Ventricular fibrillation induced by reperfusion after 40 min of ischaemia was also significantly reduced from 80 to 33%. Immediately following release of the coronary artery occlusion significant increases in plasma noradrenaline and dopamine concentrations were detected in local coronary venous blood draining from the ischaemic area in control dogs. This catecholamine release was also evident in the dogs which received 2 mg kg-1 ICS 205-930 but was less marked. Thus the antiarrhythmic activity of ICS 205-930 may be related to antagonism of detrimental effects of 5-HT, such as the ability to facilitate the release of noradrenaline from sympathetic nerve terminals in the heart, although other mechanisms may be involved.

Topics: Animals; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Catecholamines; Coronary Disease; Dogs; Dopamine; Epinephrine; Female; Hemodynamics; Indoles; Male; Norepinephrine; Tropisetron