Chronic tocainide therapy for refractory high-grade ventricular arrhythmias

Clinical Cardiology
C I HaffajeeJ E Dalen

Abstract

Tocainide, an oral analog of lidocaine, was evaluated as a long-term antiarrhythmic agent in 21 patients with symptomatic complex ventricular ectopic activity (10 with hemodynamically significant ventricular tachycardia) refractory to currently available antiarrhythmics singly, and in combination for periods of 3 days to 35 months (mean 13.6 months). Tocainide appeared to be an effective and safe agent for the control of these refractory symptomatic ventricular arrhythmias in 14 of the 21 patients (66%). Minor central nervous system and gastrointestinal side effects were present in most of the patients, usually early on in therapy, and only precluded long-term use in 2 patients. Furthermore, lidocaine responsiveness was a good predictor of tocainide effectiveness in this group of patients. Tocainide precipitated atrioventricular (A-V) block in one patient with pre-existing A-V nodal disease; two patients developed a skin rash while on tocainide therapy. These two patients had previously developed lupus-like syndromes and skin rashes while on procainamide. The ANA titers had been falling in these two patients while on tocainide, and in one of these patients with true systemic lupus erythematosus, rechallenge with tocainide faile...Continue Reading

References

May 22, 1978·The American Journal of Cardiology·D C HarrisonR A Winkle
May 1, 1978·Circulation·R A WinkleD C Harrison
Apr 1, 1978·The American Journal of Cardiology·E N MooreR A Moller
Jun 1, 1977·American Heart Journal·J T BiggerR H Heissenbuttel
Dec 1, 1977·Circulation·R L WoosleyJ A Oates

❮ Previous
Next ❯

Citations

Jan 1, 1985·European Journal of Clinical Pharmacology·J BraunU Gessler
Mar 23, 2002·Journal of the American Animal Hospital Association·Nathan L Bailiff, Carol R Norris
Aug 13, 1984·The American Journal of Cardiology·J C Somberg
Jul 3, 1986·The New England Journal of Medicine·D M Roden, R L Woosley

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antiarrhythmic Agents: Mechanisms of Action

Understanding the mechanism of action of antiarrhythmic agents is essential in developing new medications as treatment of cardiac arrhythmias is currently limited by the reduced availability of safe and effective drugs. Discover the latest research on Antiarrhythmic Agents: Mechanism of Action here.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Anti-Arrhythmic Drug Therapies

Anti-arrhythmic drugs are used to prevent abnormal heart rhythms. These medications are used in conditions including, ventricular tachycardia, ventricular fibrillation and atrial fibrillation. Discover the latest research on anti-arrhythmic drug therapies here.