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Long‐Term Antiarrhythmic Therapy With Cibenzoline
Author(s) -
Mohiuddin Syed M.,
Hilleman Daniel E.,
Esterbrooks Dennis,
Mooss Aryan N.,
Stengel Lois A.
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.tb03038.x
Subject(s) - medicine , cardiology , ventricular tachycardia , discontinuation , adverse effect , placebo , anesthesia , proarrhythmia , ejection fraction , heart failure , qt interval , pathology , alternative medicine
This single‐blind, placebo‐controlled study evaluated long‐term therapy with cibenzoline in 19 patients with chronic ventricular arrhythmias. Antiarrhythmic efficacy, defined as ≥75% reduction in single premature ventricular complexes (PVCs), ≥90% reduction in paired PVCs, and total abolition of ventricular tachycardia (VT), was established after dose titration in 14 of 19 (74%) patients. Mean frequency of single PVCs was reduced by 65%, mean paired PVC frequency was reduced by 68%, and mean VT event frequency was reduced by 82%. Antiarrhythmic efficacy was maintained during long‐term therapy in five of the 14 (36%) short‐term responders. Of the nine patients who discontinued cibenzoline during long‐term follow‐up, five had a loss of arrhythmia control, three failed to redevelop arrhythmias during placebo reintroduction, and one developed an adverse reaction. Three patients (16%) experienced a proarrhythmic effect. Echocardiographic evaluation did not reveal any deleterious effect of cibenzoline on left ventricular function in the group as a whole. In six patients with preexisting left ventricular dysfunction, left ventricular ejection fraction and fractional shortening improved significantly ( P < .05) during cibenzoline therapy. Adverse effects occurred in seven patients (37%) but necessitated drug discontinuation in only one patient (5%). Cibenzoline provides effective short‐term therapy for patients with chronic ventricular arrhythmias. Long‐term therapy must be assessed periodically to ensure continued efficacy. Drug‐related adverse effects occur infrequently. Cibenzoline can be used safely in patients with compensated left ventricular dysfunction .