Mexiletine for ventricular arrhythmias in patients with chronic coronary syndrome: a cohort study
| Autor: | Carla Paolini, Stefano Cavedon, Giacomo Mugnai, Cosimo Perrone, Claudio Bilato, Alessandro Mecenero |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Pharmacological therapy medicine.medical_treatment Myocardial Ischemia Amiodarone Catheter ablation Mexiletine Coronary Artery Disease 030204 cardiovascular system & hematology Implantable defibrillator Cohort Studies 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans In patient cardiovascular diseases 030212 general & internal medicine Contraindication Aged Aged 80 and over business.industry General Medicine Middle Aged Defibrillators Implantable Ventricular Fibrillation cardiovascular system Cardiology Tachycardia Ventricular Female Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents Cohort study medicine.drug |
| Zdroj: | Acta cardiologica. 77(3) |
| ISSN: | 1784-973X |
| Popis: | The pharmacological therapy of ventricular arrhythmias in patients with unsuccessful or not feasible catheter ablation and contraindication or inefficacy to amiodarone and beta-blockers, is controversial. The present study investigated the effectiveness and tolerability of mexiletine in patients with recurrent ventricular arrhythmias and ischaemic heart disease, when the conventional antiarrhythmic therapy failed.We enrolled all consecutive patients with unsuccessful/not feasible catheter ablation and ineffective/contraindicated amiodarone or beta-blockers, which started the mexiletine treatment for refractory ventricular tachycardia (VT) or ventricular fibrillation (VF) between January 2010 and January 2020. The primary endpoint was the total number of VT/VF episodes after the beginning of mexiletine therapy. The 2 secondary endpoints were the overall number of therapies released by implantable cardioverter-defibrillators (ICDs) and the discontinuation of the pharmacological therapy. The events occurring during the mexiletine treatment period were compared with those observed in a matched duration interval before the initiation of therapy.Thirty-four consecutive patients (27 males, 79.4%; mean age 74.0 ± 9.5 years) with ischaemic heart disease were finally analysed. The median of mexiletine treatment was 26.5 months (interquartile range: 18.75-38.25 months). After the mexiletine start, VT/VF episodes and ICD interventions significantly decreased (respectively: 74 vs 33 episodes,The treatment period following the mexiletine start was associated with a significant reduction of ventricular arrhythmias. The rate of side effects requiring dosage reduction or interruption was not neglectable. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|