Nasal Spray Offers Self-Treatment For Rapid Heartbeat, Study Shows

A fast-acting nasal spray may allow people who suffer from a common heart complaint to treat it themselves as soon as they develop symptoms.

Patients experiencing a rapid heartbeat – known as tachycardia – could use the simple treatment without medical supervision, according to a new study published in the Journal of the American Heart Association.

The findings showed that etripamil, a rapid and short-acting experimental medication formulated to be delivered via nasal spray, restored a normal heart rhythm in less than 30 minutes in most users – sparing them a trip to the hospital room to receive intravenous medication.

Participants were able to detect when they were experiencing tachycardia – a heart rate of more than 100 beats per minute – and use the medication appropriately and safely.

Around one in 300 adults experience intermittent periods of tachycardia every year, according to an American research team.

The new medication is awaiting approval from the US Food and Drug Administration.

“This is a potential new and exciting option for patients to safely self-treat their rapid heartbeat without direct medical supervision to avoid emergency room visits and medical interventions,” said Study lead author Professor James Ip, of Weill Cornell Medicine at New York-Presbyterian Hospital. 

The current standard treatment during an episode of tachycardia is for the patient to slow their heart rate by performing physical actions called vagal maneuvers, one of which is done by trying to bear down, achieved by breathing out with the stomach muscles but not let air out of the nose or mouth.

Ip says those types of actions can make the vagus nerve slow electrical conduction through the atrioventricular (AV) node, which regulates the timing of the electrical pulses to the lower portion of the heart.

If the self-administered vagal maneuvers are not effective – which happens up to 40 percent of the time, the person should seek immediate treatment of intravenous medication to return the heart rate to normal.

Ip said around 50,000 emergency room visits a year in the United States are for paroxysmal supraventricular tachycardia.

In a previous study, people with the disorder treated themselves with either etripamil or a placebo nasal spray for a single episode of rapid heartbeat.

Participants applied an electrocardiogram (ECG) patch at the onset of symptoms, did 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 that study, the first time that etripamil was used without direct supervision, normal heart rhythms were restored within 30 minutes in just over half (54 percent) of patients, compared to 35 percent with a placebo, and the medication was found to be safe and well tolerated.

All the participants in that trial were invited to join the new study that allowed patients to self-treat with etripamil during multiple episodes of paroxysmal supraventricular tachycardia (PSVT).

Of the 169 patients enrolled, with an average age of 58, 105 self-administered at least one dose of etripamil (70 mg) during the study period.

Etripamil restored heart rate to normal within 30 minutes in 60.2 percent of the 188 verified PSVT episodes and within an hour in 75.1 percent of the episodes.

Of the 40 participants who self-treated two episodes, 63.2 percent responded to the medication within 30 minutes.

Nine people (23 percent) did not convert to a normal heart rate on either episode, while 21 (53 percent) converted to a normal heart rate on both episodes.

Almost a third of the participants (32.4 percent) reported one or more side effects from the medication, most commonly mild-to-moderate nasal congestion or discomfort, or a runny nose. There were no serious heart-related adverse events.

”There are no great options for patients to self-treat paroxysmal supraventricular tachycardia, and this condition can cause significant distress and anxiety,” said IP. 

“Similar to an albuterol inhaler for asthma patients or an epinephrine pen for patients that have severe allergies or anaphylaxis, etripamil nasal spray may be a great option for people who have paroxysmal supraventricular tachycardia.”

Produced in association with SWNS Talker

Edited by Judy J. Rotich and Newsdesk Manager