New nasal spray offers hope for heart rhythm disorder

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A recent clinical trial conducted by Weill Cornell Medicine has demonstrated that a nasal spray named etripamil can effectively and safely manage episodes of a heart rhythm disorder called paroxysmal supraventricular tachycardia (PSVT) right from home.

This breakthrough could significantly reduce the need for hospital visits for many patients.

PSVT is a condition where the heart suddenly starts beating very fast due to abnormal electrical signals in the heart’s upper chambers.

While not typically life-threatening, these episodes can cause symptoms like chest pain, dizziness, and shortness of breath, often sending patients to the emergency room.

The study, published in the Journal of the American College of Cardiology, involved 1,116 participants across sites in the United States, Canada, and South America.

It shows that etripamil can be used safely by a wide variety of patients without direct supervision from a doctor.

Traditionally, managing PSVT could require a trip to the hospital to receive intravenous medication.

Some patients might even need a more invasive procedure, called cardiac ablation, which involves navigating special wires through the blood vessels to the heart to fix the electrical faults causing the rapid beats.

The latest research by Dr. James Ip and his team builds on previous studies, showing that patients could relieve their symptoms in about 17 minutes on average using etripamil.

Most patients experienced relief from their heart symptoms within an hour after using the spray. The study also noted that etripamil could be used safely for multiple episodes of PSVT.

Dr. Ip, a professor of clinical medicine and a cardiologist at NewYork-Presbyterian/Weill Cornell Medical Center, has been a leading figure in exploring the potential of etripamil. It is worth noting that Dr. Ip is also a member of the steering committee for Milestone Pharmaceuticals, the company behind etripamil.

In this trial, unlike earlier ones, patients did not need a supervised test dose and included individuals with other heart rhythm conditions like atrial fibrillation, who were previously not studied.

The use of etripamil is quite straightforward. Patients simply administer the nasal spray themselves. Following the dosage, they monitor their heart with a home electrocardiogram monitor for an hour. If needed, they could take another dose to manage up to four episodes of PSVT.

While etripamil was generally well-tolerated, some patients reported mild nasal symptoms such as a runny nose or nasal congestion after use. These symptoms tended to decrease with subsequent uses.

This nasal spray represents a promising step forward in the at-home management of PSVT, potentially easing the burden on both patients and healthcare systems by reducing the frequency of emergency room visits and hospitalizations.