Long-term mexiletine for ventricular arrhythmia

Area of Science:

• Cardiology
• Pharmacology

Background:

• Ventricular tachyarrhythmias (VT) pose a significant risk, often requiring advanced treatment.
• Conventional antiarrhythmic drugs may be ineffective for refractory VT cases.

Purpose of the Study:

• To evaluate the long-term efficacy and safety of mexiletine in patients with refractory ventricular tachyarrhythmias.

Main Methods:

• A cohort of 313 patients with refractory VT was assessed.
• 107 patients who responded well and tolerated mexiletine short-term continued long-term therapy.
• Follow-up averaged 22.8 months, monitoring mortality, arrhythmia recurrence, and side effects.

Main Results:

• 19 deaths occurred during follow-up (17.8%), with 11 sudden deaths (3.6% per year).
• Recurrent ventricular arrhythmia occurred in 14 patients (4.9% per year).
• Side effects were observed in 13 patients, primarily gastrointestinal and neurological.

Conclusions:

• Mexiletine demonstrates effectiveness and good tolerability for long-term management of refractory ventricular tachyarrhythmias.
• Individualized treatment and careful patient selection are key to successful long-term mexiletine therapy.