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The effect of tolterodine 4 and 8mg on the heart rate variability in healthy subjects

Schiffers, Maya ; Sauermann, Peter ; Schurch, Brigitte ; Mehnert, Ulrich

In: World Journal of Urology, 2010, vol. 28, no. 5, p. 651-656

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    Titre
    • The effect of tolterodine 4 and 8mg on the heart rate variability in healthy subjects
    Auteur
    • Schiffers, Maya. Neuro-Urology, Spinal Cord Injury Center, University of Zurich, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
    • Sauermann, Peter. Department of Urology, University Hospital Zurich, Zurich, Switzerland
    • Schurch, Brigitte. Neuro-Urology, Spinal Cord Injury Center, University of Zurich, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
    • Mehnert, Ulrich. Neuro-Urology, Spinal Cord Injury Center, University of Zurich, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:320018
    Summary
    Purpose: To investigate the potential effect of tolterodine on the human heart rate variability (HRV). Oral antimuscarinic treatment for overactive bladder might significantly alter HRV, which is an important predictor for cardiac and all-cause mortality. Yet, little information exists regarding the influence of oral antimuscarinics on the HRV. Methods: Healthy female volunteers were randomly assigned to either placebo, tolterodine extended release (ER) 4 or 8mg. Before and 4h post treatment, a 10min electrocardiogram (ECG) was recorded in supine position. Frequency domain and time domain analysis of both ECG measurements resulted in very low frequency (VLF), low frequency (LF), and high frequency (HF) data, the root mean square of differences of successive NN (=normal to normal, i.e. interval between two R-peaks) intervals (RMSSD), and the standard deviation of the NN intervals (SDNN). Results: Thirty subjects (mean age: 23.7±2.3years) were investigated. Placebo caused no significant HRV changes. Tolterodine 4mg significantly increased heart rate (HR) and significantly decreased VLF. Tolterodine 8mg significantly decreased HF, VLF, RMSSD and SDNN and significantly increased HR and LF/HF ratio. The changes observed with 4mg were not significantly different versus placebo, but 8mg significantly increased LF/HF as compared to placebo. Conclusions: A single dose of 8mg tolterodine ER, but not 4mg seems to reduce resting HRV versus placebo in young healthy subjects. This might be particular relevant for patients with pre-existing cardiac conditions on daily overactive bladder drug treatment and should be further investigated in larger trials