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[The effectiveness of barucainide in supraventriculr and ventricular arrhythmias]
1Pensionsversicherungsanstalt der Arbeiter, Ludwig-Boltzmann Institut für Rehabilitation interner Erkrankungen, Saalfelden.
Insights
Barucainide effectively reduced premature ventricular contractions (PVCs) and suppressed ventricular tachycardia in patients with coronary artery disease. This new anti-arrhythmic agent shows significant promise for managing cardiac arrhythmias.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Coronary artery disease (CAD) frequently leads to cardiac arrhythmias.
- New anti-arrhythmic agents are needed to manage ventricular arrhythmias in CAD patients.
Purpose of the Study:
- To evaluate the anti-arrhythmic efficacy of barucainide, a novel Class IB agent.
- To assess the impact of barucainide on premature ventricular contractions (PVCs) and ventricular tachycardia in patients with CAD.
Main Methods:
- An open-label therapeutic study involving 15 patients with CAD, most with a history of myocardial infarction.
- Barucainide (150 mg twice daily) was administered for 5 days after a 3-day placebo run-in.
- 24-hour Holter monitoring and plasma level determination were conducted during placebo and treatment periods.
Main Results:
- Barucainide significantly reduced PVCs from a median of 92.4/h to 7.9/h (p < 0.01).
- Couplets decreased significantly from 0.6/h to 0.1/h (p < 0.05).
- Ventricular tachycardia was suppressed in all 4 patients who had it; 10 patients showed >80% reduction in PVCs.
Conclusions:
- Barucainide demonstrates significant anti-arrhythmic efficacy in patients with CAD.
- The agent effectively reduces PVCs and suppresses ventricular tachycardia with minimal effects on hemodynamic parameters.
Abstract:
The anti-arrhythmic efficacy of barucainide, a new class IB anti-arrhythmic agent, was evaluated in an open-label therapeutic study in a total of 15 patients with coronary artery disease. The majority of patients had a history of myocardial infarction. After a 3-day placebo run-in period barucainide was administered at a dose of 150 mg b.d. for 5 days followed by a 4-day placebo wash-out period. 24-h Holter monitorings were recorded in the run-in period, on day 4 of the treatment period, and on day 3 of the wash-out period. In addition, plasma levels were determined in all three periods. Statistical evaluation of the 24-h arrhythmia analyses revealed a decrease of premature ventricular contractions (PVCs) in all treated patients. Before treatment PVCs occurred at a median of 92.4/h (minimum 19/maximum 1537 PVCs/h); this value was reduced during treatment to a median of 7.9 (0/427) PVCs/h (p less than 0.01). A similar result was also found for the couplets which decreased significantly from a median (min/max) of 0.6 (0/11)/h before treatment with barucainide to 0.1 (0/3)/h after treatment (p less than 0.05). In 10 of 15 patients premature ventricular contractions were reduced by more than 80%. Ventricular tachycardia present in 4 of 15 patients was suppressed in all cases. Barucainide had only a slight effect on PQ and QTc intervals, QRS duration, heart rate, and blood pressure.