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Long-term Efficacy and Side Effects in Patients With Chronic Drug-Resistant Potentially Lethal Ventricular Arrhythmias

Nicholas Z. Kerin, MD; Eric Aragon, MD; Gheorghe Marinescu, MD; Kathy Faitel, RN, BSN; Howard Frumin, MD; Melvyn Rubenfire, MD

Arch Intern Med. 1990;150(2):381-384.

Abstract
• The antiarrhythmic efficacy of mexiletine hydrochloride (Mexitil) was evaluated in 100 patients with potentially lethal and drug-resistant ventricular arrhythmia. The efficacy of arrhythmia suppression was assessed by Holter monitoring. The overall arrhythmia suppression of ventricular premature contractions of 70% and greater was low and seen in only 22% of patients, with an additional 16% responding to a combination of mexiletine and an additional antiarrhythmic drug. The suppression of high-grade forms, couplets of 90% and greater, and complete abolition of nonsustained runs of ventricular tachycardia was achieved in 22% of patients, with 9% responding to the addition of another antiarrhythmic agent. Ventricular premature contractions, couplets, and nonsustained ventricular tachycardia were suppressed in only 16% of the cohort. The drug was poorly tolerated, with intolerable side effects developing in 49% of patients receiving mexiletine alone and in 57% of patients receiving a combination of antiarrhythmic agents. Tolerable adverse effects were relatively common but transient and dose related.

(Arch Intern Med. 1990;150:381-384)

Author Affiliations
From the Department of Medicine, Section of Cardiovascular Diseases, Sinai Hospital of Detroit, Mich, and Wayne State University School of Medicine, Detroit.

Footnotes
Accepted for publication September 1,1989.

Reprint requests to Sinai Hospital of Detroit, 6767W Outer Dr, Detroit, MI 48235-2899 (Dr Kerin).

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