Effects of phenytoin on the ventricular tachyarrhythmias of chronic Chagas' disease.
The effects of phenytoin on the ventricular tachyarrhythmias of 11 patients with chronic chagasic myocarditis were investigated, and correlated with the serum phenytoin levels. Physical examination, laboratory tests and 24- to 48-h ambulatory electrocardiographic recordings were performed before, during (7-14 days) and after treatment with phenytoin (4-6 mg/kg/day, orally, in three divided doses). Significant (greater than 90%) reduction of couplets, bigeminy and runs of ventricular tachycardia were observed in 50-67% of the patients, whereas the frequency of isolated premature ventricular contractions was significantly (greater than 70%) reduced in only 2 patients (18%). Proarrhythmic activity was not observed and adverse side effects were of mild intensity and usually transient, except in one patient, who developed pruritus and skin rash in the presence of toxic phenytoin serum levels (27 micrograms/ml). It is suggested that phenytoin may be useful for the control of repetitive forms of ventricular tachyarrhythmias in selected patients with chronic chagasic myocarditis.
Suarez-Kurtz
G
G
Department of Basic and Clinical Pharmacology, Universidade Federal do Rio de Janeiro, Brazil.
Lorga
A M
AM
Moraes
F D
FD
D000328:Adult; D002598:Chagas Cardiomyopathy / Q000150:complications* / Q000503:physiopathology; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010672:Phenytoin / Q000009:adverse effects / Q000627:therapeutic use*; D013610:Tachycardia / Q000188:drug therapy* / Q000503:physiopathology
D010672:Phenytoin