Antiarrhythmic efficacy of penticainide and comparison with disopyramide, flecainide, propafenone and mexiletine by acute oral drug testing

Silvia G. Priori, Oscar Bonazzi, Mario Facchini, Tiziana Varisco, Peter J. Schwartz

Research output: Contribution to journalArticle

Abstract

The antiarrhythmic efficacy of a new class I agent, penticainide, was evaluated by acute oral drug testing and compared in the same patient population with the efficacy of disopyramide, flecainide, mexiletine and propafenone. Twenty-five patients with high-grade chronic ventricular arrhythmias entered the study. During acute oral drug testing, penticainide (7 mg/kg) was effective (more than 90% reduction in ventricular premature complexes and complete abolition of class 4A and 4B arrhythmias) in 17 of 25 subjects (68%). The mean plasma level of the drug at 90 minutes was 4.4 ± 1.9 μg/ml; at the same time increases in the PQ interval (from 168 ± 27 to 189 ± 31 ms, p <0.0001) and QRS duration (from 89 ± 14 to 96 ± 18 ms, p <0.001) were observed, the QTc was slightly but not significantly shortened in the overall population; however, in the subgroup with a basally prolonged QTc (n = 8), a significant reduction was observed (from 456 ± 8 to 440 ± 18 ms, p <0.02). No adverse effects were reported. The antiarrhythmic efficacy of the other drugs tested in the same population was: disopyramide, 12 of 19 (63%); flecainide, 13 of 24 (54%); propafenone, 13 of 24 (54%); and mexiletine, 7 of 20 (35%). Penticainide appears to be a well-tolerated and effective compound of potential value for treatment of ventricular arrhythmias.

Original languageEnglish
Pages (from-to)1068-1072
Number of pages5
JournalThe American Journal of Cardiology
Volume60
Issue number13
DOIs
Publication statusPublished - Nov 1 1987

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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