Efficacy and tolerability of mexiletine treatment in patients with recurrent ventricular tachyarrhythmias and implantable cardioverter-defibrillator shocks

• DOI: 10.5603/kp.2017.0189
• Publication Date: 2017-10-23T07:37:54Z
• Authors: Marcin Sobiech; Michał Lewandowski; Dariusz Zając; Aleksander Maciąg; Paweł Syska; Joanna Ateńska-Pa...; Ilona Kowalik; Maciej Sterliński; Hanna Szwed; Mariusz Pytkowski
• Keywords: Mexiletine; Tolerability; Discontinuation; Interquartile range

Background: Antiarrhythmic treatment of patients with recurrent ventricular tachyarrhythmia, in whom catheter ablation and amiodarone were ineffective or contraindicated, is an unsolved clinical problem. Aim: The study aims to evaluate the efficacy tolerability mexiletine tachyarrhythmias and/or electrical storm events, standard strategies failed prevent tachyarrhythmia. Methods: We performed a retrospective cohort analysis all treated for tachycardia fibrillation our institution between January 2011 September 2015. primary endpoints total number events tachycardia/ventricular (VT/VF) episodes after beginning therapy. Secondary implantable cardioverter-defibrillator (ICD) therapies discontinuation Events compared matched duration period before initiating mexiletine. Patients served as self-controls. Results: Seventeen included study; 11 males. Mean age was 64.2 ± 15.4 years. median time eight months (interquartile range [IR]: 1–22 months). dose 600 mg/day 13 400 four patients. In modified during from depending on decision. Treatment significantly reduced (14 vs. two episodes; IR 17 patients: 1 [0–1] 0 [0–0], p = 0.0010), VT/VF (285 74 7 [5–27] [0–5], 0.0115), ICD interventions (317 interven­tions nine interventions; 10 [5–25] [0–2], 0.0006), comparison initiation treatment. 14 out (82%) sufficient observed. Only three (18%) severe side effects occurred requiring Conclusions: Mexiletine sufficiently tolerated antiarrhythmic drug short-term tachyarrhyth­mias studied population. may be effective recurring events.