Mexiletine therapy in patients with chronic drug-resistant malignant ventricular arrhythmias

ABSTRACT

The authors report their overall experience with 138 patients receiving mexiletine for chronic drug-resistant ventricular arrhythmias. Of these 138 patients, 26 (19%) were "early failures" (that is, experiencing refractory arrhythmias or intolerant to therapy prior to initial hospital discharge) and an additional 22 patients (16%) were "late failures" (that is, experiencing refractory arrhythmias or intolerant to therapy after hospital discharge). Chronic oral maintenance therapy was successful for 90 patients (65%). Nine (7%) arrhythmia-related deaths occurred. Side effects were common (28% initially and 52% during chronic maintenance therapy), but discontinuation of the drug was only required for 9 patients (7%). No significant biochemical abnormalities or electrocardiographic conduction disturbances were observed. Mexiletine appears to be a clinically useful and safe antiarrhythmic agent for the treatment of chronic drug-resistant ventricular arrhythmias.