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Tocainide for refractory symptomatic ventricular arrhythmias.

P J Podrid, B Lown

    The American Journal of Cardiology
    |April 1, 1982
    PubMed
    Summary
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    Tocainide, an oral antiarrhythmic drug, effectively treated malignant ventricular arrhythmias in 46% of patients. Lidocaine effectively predicted patient response to tocainide therapy.

    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Malignant ventricular arrhythmias pose a significant risk, often proving refractory to conventional antiarrhythmic drugs.
    • Tocainide, an oral analog of lidocaine, presents a potential therapeutic option for these challenging cases.

    Purpose of the Study:

    • To evaluate the efficacy and safety of tocainide in patients with recurrent malignant ventricular arrhythmias.
    • To determine if pre-treatment lidocaine response could predict tocainide efficacy.

    Main Methods:

    • 120 patients with refractory ventricular arrhythmias underwent a washout period followed by tocainide therapy (1200-2400 mg/day).
    • Efficacy was assessed via ambulatory ECG monitoring, exercise stress testing, and electrophysiologic studies.
    • Adverse effects and long-term outcomes were monitored.

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    Main Results:

    • Tocainide demonstrated efficacy in 46% of patients (55 out of 120).
    • Central nervous system adverse effects were reported in 35% of patients.
    • Lidocaine predicted tocainide response in 78% of cases.

    Conclusions:

    • Tocainide is an effective oral antiarrhythmic agent for a subset of patients with malignant ventricular arrhythmias.
    • Pre-treatment with lidocaine can help predict the likelihood of a positive response to tocainide.
    • Further investigation into managing tocainide-related adverse effects is warranted.