[Prajmalium bitartrate in hyperkinetic ventricular arrhythmias in infarct patients during rehabilitation]

The present study was designed to assess the antiarrhythmic Prajmalium Bitartrate (PB) efficacy in the long term treatment of 22 patients with recent myocardial infarction and persistent, frequent, polimorphous, repetitive (two or more in a row) ventricular premature complexes (VPCs). VPCs were exposed by means of 24-hours ambulatory monitoring. The acute drug testing with a single dose of PB (30 mg) was followed by multiple maintenance therapy with a dose decreasing from 60 to 40 mg every day. Than, the long term antiarrhythmic action was evaluated by both monitoring and exercise stress testing (EST), symptom self-limited, in a 7 months and 28 days follow-up. A favorable therapeutic effect, with a reduction of VPCs frequency greater than 85% and the suppression of their greater Lown degrees, was obtained in 13 cases (59.2%) using PB alone and in 6 cases (27.2%) using PB associated with Amiodarone in 5 patients and with Metoprololo in one. No VPCs were present or they were less than 2 every 3 minutes during EST. Fourteen patients reported a recurrence of VPCs when the drug was stopped for 24-28 hours, after 3-5 months of the treatment. In 3 patients (13.6%) the PB was uneffective. In a case there was, during the acute drug testing, a paradox increasing of the arrhythmias, and in the other two an abnormal lengthening of QTc interval, while arrhythmia was unchanged. PB, alone or associated with other antiarrhythmic drugs, appears a well tolerated, handy and effective agent and it can be proposed as a drug of first choice for controlling VPCs.