The specific aim of this study is to determine whether hydroquinidine administration can prevent heart from appearance of ventricular arrhythmia detected by the automatic implantable defibrillator (ICD).
During this double-blind randomized cross-over study, patient will receive during 18 months treatment 1 (hydroquinidine or placebo) and, after 7 days of wash-out, patient will receive treatment 2 (meaning for example hydroquinidine if treatment 1 was placebo). Time length before arisen of an appropriate shock registered on the defibrillator (meaning due to ventricular arrhythmia) will be assessed during treatment 1 period and treatment 2 period.We hypothesized that hydroquinidine administration will enhance time length before arisen of an appropriate shock and thus mean that hydroquinidine administration can prevent heart from appearance of ventricular arrhythmia. Patient's defibrillator recordings will be analysed every 6 months plus when patient experiences an ICD shock. If the shock delivered by the ICD is appropriate and happens during treatment 1 period, patient will switch to treatment 2 period after 7 days of wash-out. If the shock delivered by the ICD is appropriate and happens during treatment 2 period, study will be finished for this patient.Before starting the study, each patient will test which dose of hydroquinidine she/he requires to have an hydroquinidine concentration in her/his blood included between 3 and 6 µmol/L. Planned enrollment: 200 subjects (60 being symptomatic with histories of aborted sudden cardiac death or of ventricular fibrillation, 70 being symptomatic with histories of syncope considered as of arrhythmic origin, 70 being asymptomatic with a spontaneous type 1 ECG and a positive electrophysiological exploration)
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
64
capsules of 300 mg LP, 1 or 2 or 3 times per day : frequency will be determined by tests after patient inclusion before her/his randomization
capsules of placebo have same design and color than capsules of hydroquinidine except for their content as they contain sugar and not hydroquinidine
CHU Amiens
Amiens, France
CHU Angers
Angers, France
CHU Bordeaux
Bordeaux, France
To determine whether hydroquinidine enhances time length before arisen of an appropriate shock registered on the automatic implantable defibrillator (meaning due to ventricular arrhythmia)
Time frame: 3 years after patient randomization
To evaluate number and frequency of inappropriate shock with and without hydroquinidine
Time frame: 3 years after patient randomization
To evaluate the number of tachycardia or of ventricular fibrillations detected by the defibrillator but not having required any treatment
Time frame: 3 years after patient randomization
To evaluate number of syncope reported by the patient but for which no ventricular arrhythmias has been detected by the defibrillator
Time frame: 3 years after patient randomization
To evaluate the number and frequency of adverse events appeared under hydroquinidine treatment
Time frame: 3 years after patient randomization
To evaluate interest of the electrophysiological exploration for determining chances of success of an hydroquinidine
Time frame: 3 years after patient randomization
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CHU Brest
Brest, France
CHU Grenoble
Grenoble, France
CHRU Lille
Lille, France
CHU Lyon
Lyon, France
AP-HM Marseille
Marseille, France
CHU Montpellier
Montpellier, France
CHU Nancy
Nancy, France
...and 7 more locations