Comparative Investigation of the Antiarrhythmic Effect of Propafenone (Rytmonorm) and Lidocaine in Patients with Ventricular Arrhythmias during Acute Myocardial Infarction

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Abstract
Propafenone, a new class I antiarrhythmic drug, given as a bolus injection followed by oral medication, or lidocaine were given to 20 consecutive patients admitted with chest pain suggesting acute myocardial infarction and showing high grades, i.e., multiform, pairs or R-on-T premature ventricular complexes or short runs of ventricular tachycardia. Before institution of therapy the mean number (.+-. 1 SD) of premature ventricular contractions (PVC) per hour was 169 .+-. 123 in the lidocaine group and 324 .+-. 440 in the propafenone group. During the next 24 h lidocaine reduced the numbers of PVC by 73% and propafenone by 75%. The mean number (.+-. 1 SD) of 5-min periods with high grade PVC was 4.3 .+-. 2.9 in the lidocaine group and 5.8 .+-. 4.5 in the propafenone group. During therapy this number was equally reduced in both groups to 2.4. One patient in the lidocaine group developed ventricular fibrillation and 3 patients in the propafenone group were excluded because of increasing numbers of PVC. One patient in the propafenone group showed a torsade-de-pointes ventricular tachycardia.