[Effect of barucainide on left ventricular ejection fraction in patients with ventricular cardiac arrhythmias].
We studied the effect of barucainide, an investigational class lb antiarrhythmic drug, on ventricular arrhythmias and left-ventricular ejection fraction in 10 patients with frequent and complex ventricular arrhythmias (Lown grade 4a/4b). The study was conducted as a single-blind and placebo-controlled trial. With placebo, mean frequency of ventricular arrhythmias was 6238 VPB/24 h, 510 couplets/24 h, and 24 salvos/24 h. Mean left-ventricular ejection fraction was 37.6%, ranging from 18% to 58%. Therapy with barucainide (300-400 mg/day) resulted in a significant reduction of ventricular arrhythmias in 7 of 10 patients; in one patient barucainide had a clear proarrhythmic effect. Over all, left-ventricular ejection fraction (37.6% +/- 12% with placebo vs 36.1% +/- 11% with barucainide) was not significantly altered. In one patient, however, it was depressed by more than 5%; one patient complained of shortness of breath during exercise. None of the four patients with an initial ejection fraction below 35% showed a drop of ejection fraction during therapy with barucainide. The only main adverse effect was a small, but significant (p less than 0.005) rise of serum-kreatinine (1.13 +/- 0.26 vs 1.39 +/- 0.38 mg%) in all patients. We conclude that barucainide has a good antiarrhythmic effect and is usually well tolerated in patients with markedly depressed left-ventricular function. The mechanism causing the rise of serum-kreatinin, however, needs to be clarified in further studies.
Scheininger
M
M
Klinikum Innenstadt, Ludwig-Maximilians-Universität München.
Dziersk
J
J
Kullak
W
W
Kors
A
A
Köhler
J A
JA
Theisen
K
K
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D005117:Cardiac Complexes, Premature / Q000188:drug therapy*; D002302:Cardiac Output / Q000187:drug effects*; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy; D003327:Coronary Disease / Q000188:drug therapy; D004562:Electrocardiography / Q000187:drug effects*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy; D011725:Pyridines / Q000627:therapeutic use*; D015635:Radionuclide Ventriculography / Q000187:drug effects; D016037:Single-Blind Method; D016277:Ventricular Function, Left / Q000187:drug effects*
D000889:Anti-Arrhythmia Agents; D011725:Pyridines; C057806:barucainide
Einfluss von Barucainid auf die linksventrikuläre Auswurffraktion bei Patienten mit ventrikulären Herzrhythmusstörungen.