Prostaglandin E₁: Electrophysiological safety in patients with congestive heart failure and peripheral arterial occlusive disease

Prostaglandin E₁ (PGE₁), the active ingredient of the drug alprostadil-α-cyclodextrin, has been effective in mitigating the clinical manifestations of peripheral arterial occlusive disease (PAOD). PGE₁ often is administered to patients with the potential for developing serious arrhythmias, presenting potential safety hazards if the drug caused or potentiated arrhythmias. However, PGE₁ has antiadrenergic properties and, theoretically, might have an antiarrhythmic action. Therefore, the effect of PGE₁ on frequency and severity of atrial and ventricular arrhythmias was evaluated from 48-hour electrocardiographic recordings in patients receiving PGE₁ therapy for severe PAOD. No significant effects on arrhythmia frequency or severity, and no evidence of proarrhythmia, was apparent after PGE₁ administration.