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Tocainide therapy for refractory ventricular arrhythmias.

D M Roden, D M Roden, S B Reele

    American Heart Journal
    |July 1, 1980
    PubMed
    Summary
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    Tocainide effectively suppressed ventricular arrhythmias, especially ventricular tachycardia, in patients unresponsive to other treatments. However, significant adverse effects limited its long-term use.

    Area of Science:

    • Cardiology
    • Pharmacology
    • Clinical Medicine

    Background:

    • Ventricular arrhythmias pose a significant clinical challenge.
    • Conventional antiarrhythmic agents have limitations in efficacy and tolerability.
    • Tocainide, an oral congener of lidocaine, was investigated as an alternative therapy.

    Purpose of the Study:

    • To evaluate the efficacy and safety of oral tocainide in patients with symptomatic ventricular arrhythmias.
    • To determine predictors of tocainide response.
    • To assess the long-term applicability of tocainide therapy.

    Main Methods:

    • Oral tocainide therapy was administered to 19 patients with refractory or intolerant ventricular arrhythmias.
    • Patients were monitored for arrhythmia suppression and adverse events.

    Related Experiment Videos

  • Responsiveness to prior lidocaine therapy was assessed as a potential predictor.

    • Main Results:

    • Fifteen of 19 patients (79%) showed a good initial response to oral tocainide.
    • Ventricular tachycardia suppression was more pronounced than for ventricular ectopic depolarizations.
    • Lidocaine responsiveness predicted tocainide efficacy.
    • Nine patients discontinued therapy due to adverse reactions (five allergic); four deaths occurred during or shortly after therapy.
    • Two patients remained on therapy for 1-4 years.

    Conclusions:

    • Tocainide demonstrates efficacy in the short-term suppression of ventricular arrhythmias, particularly lidocaine-sensitive ventricular tachycardia.
    • A high incidence of adverse effects, including allergic reactions, restricts its use in chronic therapy.
    • Tocainide may be a valuable option for selected patients requiring short-term antiarrhythmic management.