Abstract
Oral antiarrhythmic treatment with mexiletine and disopyramide was evaluated in 34 patients with recurrent sustained ventricular tachycardias by programmed ventricular stimulation, except in a few instances where spontaneous attacks occurred under therapy. Coronary heart disease was present in 17 patients, cardiomyopathy in 11, myocarditis in five, and mitral valve prolapse in one. Complete suppression of ventricular tachycardia was observed in three of 30 patients under mexiletine and in one of 25 patients under disopyramide. Disopyramide slowed the rate of the ventricular tachycardia considerably, while mexiletine had no such influence. For a mean of 24 months, 19 patients were maintained on either substance. Complete suppression of ventricular tachycardia during programmed stimulation predicted freedom from recurrences. Ventricular tachycardias recurred less frequently and at a slower rate in the other patients, but 31% have died. This study shows that complete suppression of ventricular tachycardia by mexiletine or disopyramide can be achieved only in a minority of patients with previously drug-resistant tachycardias.
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Selected References
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- ARMBRUST C. A., Jr, LEVINE S. A. Paroxysmal ventricular tachycardia; a study of 107 cases. Circulation. 1950 Jan;1(1):28–40. doi: 10.1161/01.cir.1.1.28. [DOI] [PubMed] [Google Scholar]
- Benditt D. G., Pritchett E. L., Wallace A. G., Gallagher J. J. Recurrent ventricular tachycardia in man: evaluation of disopyramide therapy by intracardiac electrical stimulation. Eur J Cardiol. 1979 Apr;9(4):255–276. [PubMed] [Google Scholar]
- Breithardt G., Seipel L., Abendroth R. R. Comparison of the antiarrhythmic efficacy of disopyramide and mexiletine against stimulus-induced ventricular tachycardia. J Cardiovasc Pharmacol. 1981 Sep-Oct;3(5):1026–1037. doi: 10.1097/00005344-198109000-00013. [DOI] [PubMed] [Google Scholar]
- DiMarco J. P., Garan H., Ruskin J. N. Mexiletine for refractory-ventricular arrhythmias: results using serial electrophysiologic testing. Am J Cardiol. 1981 Jan;47(1):131–138. doi: 10.1016/0002-9149(81)90301-5. [DOI] [PubMed] [Google Scholar]
- Fisher J. D., Cohen H. L., Mehra R., Altschuler H., Escher D. J., Furman S. Cardiac pacing and pacemakers II. Serial electrophysiologic-pharmacologic testing for control of recurrent tachyarrhythmias. Am Heart J. 1977 May;93(5):658–668. doi: 10.1016/s0002-8703(77)80018-5. [DOI] [PubMed] [Google Scholar]
- Horowitz L. N., Josephson M. E., Farshidi A., Spielman S. R., Michelson E. L., Greenspan A. M. Recurrent sustained ventricular tachycardia 3. Role of the electrophysiologic study in selection of antiarrhythmic regimens. Circulation. 1978 Dec;58(6):986–997. doi: 10.1161/01.cir.58.6.986. [DOI] [PubMed] [Google Scholar]
- Josephson M. E., Horowitz L. N., Farshidi A., Kastor J. A. Recurrent sustained ventricular tachycardia. 1. Mechanisms. Circulation. 1978 Mar;57(3):431–440. doi: 10.1161/01.cir.57.3.431. [DOI] [PubMed] [Google Scholar]
- Kelly J. G., Nimmo J., Rae R., Shanks R. G., Prescott L. F. Spectrophotofluorometric and gas-liquid chromatographic methods for the estimation of mexiletine (Kö 1173) in plasma and urine. J Pharm Pharmacol. 1973 Jul;25(7):550–553. doi: 10.1111/j.2042-7158.1973.tb09155.x. [DOI] [PubMed] [Google Scholar]
- Mason J. W., Winkle R. A. Electrode-catheter arrhythmia induction in the selection and assessment of antiarrhythmic drug therapy for recurrent ventricular tachycardia. Circulation. 1978 Dec;58(6):971–985. doi: 10.1161/01.cir.58.6.971. [DOI] [PubMed] [Google Scholar]
- Scherlag B. J., Lau S. H., Helfant R. H., Berkowitz W. D., Stein E., Damato A. N. Catheter technique for recording His bundle activity in man. Circulation. 1969 Jan;39(1):13–18. doi: 10.1161/01.cir.39.1.13. [DOI] [PubMed] [Google Scholar]
- Steinbeck G., Manz M., Lüderitz B. Möglichkeiten und Risiken der programmierten Ventrikelstimulation bei Patienten mit chronisch rezidivierenden Kammertachykardien. Klin Wochenschr. 1981 Feb 2;59(3):111–121. doi: 10.1007/BF01477353. [DOI] [PubMed] [Google Scholar]
- Wellens H. J., Bär F. W., Vanagt E. J., Brugada P. Medical treatment of ventricular tachycardia: considerations in the selection of patients for surgical treatment. Am J Cardiol. 1982 Jan;49(1):186–193. doi: 10.1016/0002-9149(82)90293-4. [DOI] [PubMed] [Google Scholar]
