Document Detail


Intolerance and ineffectiveness of mexiletine in patients with serious ventricular arrhythmias.
MedLine Citation:
PMID:  3739884     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fifty-one patients were treated with mexiletine over 10.4 +/- 16 months. The clinical arrhythmia in 25 (49%) was ventricular fibrillation (VF), 11 (22%) had sustained ventricular tachycardia (VT), and 15 (29%) had symptomatic nonsustained VT. Ischemic heart disease was present in 33 patients (66%), cardiomyopathy in nine (17%), and valvular or congenital heart disease in nine (17%). Only six (12%) remain on the drug. Arrhythmias recurred in 21 patients (41%): seven (14%) with VF, three (5%) with sustained VT, and 11 (22%) with symptomatic nonsustained VT. Intolerable side effects occurred in another 17 (33%). Seven patients (14%) died from nonarrhythmic-related deaths while taking mexiletine. Mexiletine was combined with a conventional type IA antiarrhythmic agent in 25 patients (49%). In 12 of these 25 patients (48%), ventricular arrhythmias recurred. These findings were not significantly different from those of the group treated with mexiletine alone, where arrhythmias recurred in 9 of 26 patients (35%) (p = NS). Thus mexiletine, alone or in combination with a type IA antiarrhythmic agent, has limited clinical utility in patients with life-threatening ventricular arrhythmias.
Authors:
J E Poole; J A Werner; G H Bardy; E L Graham; W P Pulaski; C E Fahrenbruch; H L Greene
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  112     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1986 Aug 
Date Detail:
Created Date:  1986-09-17     Completed Date:  1986-09-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  322-6     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Cardiac Pacing, Artificial
Disopyramide / therapeutic use
Drug Therapy, Combination
Electrocardiography
Electrophysiology
Female
Humans
Male
Mexiletine / adverse effects*,  therapeutic use
Middle Aged
Monitoring, Physiologic
Nausea / chemically induced
Procainamide / therapeutic use
Propylamines / adverse effects*
Quinidine / therapeutic use
Recurrence
Tachycardia / diagnosis,  drug therapy*,  mortality
Tremor / chemically induced
Ventricular Fibrillation / diagnosis,  drug therapy*,  mortality
Chemical
Reg. No./Substance:
0/Propylamines; 31828-71-4/Mexiletine; 3737-09-5/Disopyramide; 51-06-9/Procainamide; 56-54-2/Quinidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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