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Lorcainide for the Treatment of Refractory Ventricular Tachycardia: Clinical and Electrophysiologic Results
Author(s) -
Hanyok James J.,
Kluger Jeffrey,
Chow Moses S. S.,
Fieldman Arnold
Publication year - 1987
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1987.tb03013.x
Subject(s) - ventricular tachycardia , refractory (planetary science) , medicine , qrs complex , adverse effect , anesthesia , refractory period , qt interval , tachycardia , effective refractory period , cardiology , physics , astrobiology
The electrophysiologic effects and antiarrhythmic efficacy of lorcainide were evaluated using programmed electrical stimulation (PES) in 14 patients with ventricular tachycardia (VT) refractory to conventional drug therapy. Lorcainide was administered orally (200–400 mg/d, eight patients), intravenously (150 mg/d, one patient), or by both routes (250–380 mg/d, five patients) prior to PES. In 13 patients undergoing both control and lorcainide PES, lorcainide increased the QRS duration (102 ± 28 to 125 ± 28 ms , P < .001) and the QT c interval (430 ± 39 to 471 ± 32 ms , P < .01) but had no effect on the RR interval (786 ± 156 to 780 ± 172 ms , P > .2). The right ventricular effective refractory period increased from 258 ± 8 to 285 ± 22 ms ( P < .001). Lorcainide prevented VT induction or resulted in induction of only well‐tolerated, nonsustained VT in six of 14 patients (43%). The cycle length of induced VT increased from 264 ± 32 to 306 ± 34 ms ( P < .01). Of six patients started on chronic therapy, four still receive lorcainide after 18 ±7 months. Adverse effects have consisted mainly of sleep disturbances. Thus, it can be stated that lorcainide is effective in certain patients with VT refractory to conventional therapy .