ANTIARRHYTHMIC EFFICACY OF MEXILETINE, PROPAFENONE AND FLECAINIDE IN VENTRICULAR PREMATURE BEATS - A COMPARATIVE-STUDY IN PATIENTS AFTER MYOCARDIAL-INFARCTION

  • 1 January 1982
    • journal article
    • research article
    • Vol. 71  (5) , 340-349
Abstract
In 12 patients with coronary artery disease, 11 of them with previous myocardial infarction, the antiarrhythmic effects of orally administered flecainide (F), mexiletine (M) and propafenone (P) were examined. The doses were 400 mg F, 600 mg M and 900 mg P daily. Administration was randomized, with a change between placebo and treatment periods for a duration of 3 and 4 days, respectively. The 3 antiarrhythmic agents significantly reduced the number of ventricular premature beats (VPB); by 94.2 (F), 80.2 (P) and 52.8% M. Repetitive VPB were reduced by .apprx. 98.8 (F), 96.8 (P) and 83.3% (M). The Lown-Index diminished by .apprx. 1.45 (F), 1.18 (P) and 0.55 classes (M), respectively. A complete suppression of VPB was obtained only in 1 patient under medication with F and P lengthened the duration of P, PQ and QRS, while M did not affect these parameters. Heart rate and QT remained unchanged. Subjective side effects of the 3 agents were similar. Without the influence on the ECG, objective side effects were missed. The long plasma half-life of F (19.0 .+-. 5.2 h) guarantees an antiarrhythmic effect over a period of 24 h if the substance is administered twice daily. The large variance of plasma half-life can cause some difficulties in finding the individually required dose of F.