Abstract
The antiarrhythmic effects of perhexiline were investigated in 13 of 20 patients with frequent and long standing ventricular extrasystoles in a double blind crossover trial using 24-hour electrocardiograph tape recordings, routine electrocardiograms, and treadmill exercise testing. With a dose of 300 to 400 mg per day, there was a significant decrease (mean 41%) in the number of ventricular extrasystoles per 24 hours. There were large differences in the individual responses to perhexiline, which were significantly related to the diurnal variations of ventricular extrasystoles: those patients whose ventricular extrasystoles disappeared spontaneously during sleep were less likely to respond to perhexiline than those whose ventricular extrasystoles persisted throughout the night. Suppression of ventricular extrasystoles was also apparent from the routine electrocardiogram and the exercise tests. Side effects (dizziness and unsteadiness) were troublesome in 5 of 20 patients. It is concluded that in selected patients perhexiline is an effective antiarrhythmic drug, and is likely to be most useful in patients with coexisting angina and ventricular extrasystoles. Because of its potential toxicity, it should not be used as a drug of first choice.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bourrat C., Viala J. J., Guastala J. P. Neuropathie périphérique après absorption prolongée de maléate de perhexiline. Deux cas. Nouv Presse Med. 1975 Oct 18;4(35):2528–2528. [PubMed] [Google Scholar]
- Campbell R. W., Dolder M. A., Prescott L. F., Talbot R. G., Murray A., Julian D. G. Comparison of procainamide and mexiletine in prevention of ventricular arrhythmias after acute myocardial infarction. Lancet. 1975 Jun 7;1(7919):1257–1260. doi: 10.1016/s0140-6736(75)92548-9. [DOI] [PubMed] [Google Scholar]
- Chiang B. N., Perlman L. V., Ostrander L. D., Jr, Epstein F. H. Relationship of premature systoles to coronary heart disease and sudden death in the Tecumseh epidemiologic study. Ann Intern Med. 1969 Jun;70(6):1159–1166. doi: 10.7326/0003-4819-70-6-1159. [DOI] [PubMed] [Google Scholar]
- Goulding L., Cobern B. Methods for tape analysis (I). Postgrad Med J. 1976;52 (Suppl 7):14–18. [PubMed] [Google Scholar]
- Hinkle L. E., Jr, Carver S. T., Stevens M. The frequency of asymptomatic disturbances of cardiac rhythm and conduction in middle-aged men. Am J Cardiol. 1969 Nov;24(5):629–650. doi: 10.1016/0002-9149(69)90451-2. [DOI] [PubMed] [Google Scholar]
- Jelinek M. V., Lohrbauer L., Lown B. Antiarrhythmic drug therapy for sporadic ventricular ectopic arrhythmias. Circulation. 1974 Apr;49(4):659–666. doi: 10.1161/01.cir.49.4.659. [DOI] [PubMed] [Google Scholar]
- Klassen G. A., Sestier F., L'Abbate A., Mildenberger R. R., Zborowska-Sluis D. T. Effects of perhexiline maleate on coronary flow distribution in the ischemic canine myocardium. Circulation. 1976 Jul;54(1):14–20. doi: 10.1161/01.cir.54.1.14. [DOI] [PubMed] [Google Scholar]
- Lhermitte F., Fardeau M., Chedru F., Mallecourt J. Polyneuropathy after perhexiline maleate therapy. Br Med J. 1976 May 22;1(6020):1256–1256. doi: 10.1136/bmj.1.6020.1256. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Niarchos A. P. Disopyramide: serum level and arrhythmia conversion. Am Heart J. 1976 Jul;92(1):57–64. doi: 10.1016/s0002-8703(76)80403-6. [DOI] [PubMed] [Google Scholar]
- Pilcher J., Chandrasekhar K. P., Rees J. R., Boyce M. J., Peirce T. H., Ikram H. Proceedings: Long-term assessment of perhexiline maleate in angina pectoris. Postgrad Med J. 1973 Apr;49(Suppl):115–118. [PubMed] [Google Scholar]
- Rowe G. G., Spring D. A., Afonso S. Systemic and coronary hemodynamic effects of perhexiline. Arch Int Pharmacodyn Ther. 1970 Oct;187(2):377–393. [PubMed] [Google Scholar]
- Vedin J. A., Wilhelmsson C. E., Wilhelmsen L., Bjure J., Ekstrom-Jodal B. Relation of resting and exercise-induced ectopic beats to other ischemic manifestations and to coronary risk factors. Men born in 1913. Am J Cardiol. 1972 Jul 11;30(1):25–31. doi: 10.1016/0002-9149(72)90120-8. [DOI] [PubMed] [Google Scholar]