title: [Combination of sotalol with the class I B substances mexiletine or tocainide in complex ventricular extrasystole].
abstract: In 34 patients with ventricular tachyarrhythmias the effect of the antiarrhythmic therapy of sotalol (160-320 mg p.o.) in combination with the type-I-B-agent mexiletine (600-800 mg p.o.) or tocainide (800-1200 mg p.o.) was studied by Holter monitoring. In all patients 2.2 +/- 1.1 drugs trials had failed, including amiodarone in 8 patients and beta blocking substances in 15 patients. The combination of sotalol with mexiletine or tocainide reduced ventricular ectopic beats by 79% and complex ventricular arrhythmias (pairs and salvoes) by 85%. A significant reduction of ventricular ectopic beats (greater than 80%) was reached in 74% of the patients, of pairs and salvoes (greater than 90%) in 79%. There was no difference in the antiarrhythmic efficacy between the combination of sotalol/mexiletine and sotalol/tocainide. Intervals of the resting ECG or laboratory values did not change significantly. In 5 patients with sotalol/tocainide and 1 patient with sotalol/mexiletine, side effects were observed which necessitated discontinuation of the treatment. The results show that sotalol, in combination with mexiletine or tocainide, has a potent antiarrhythmic effect in patients with otherwise drug-refractory ventricular arrhythmias.
mesh_terms: D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D005117:Cardiac Complexes, Premature / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000187:drug effects; D006801:Humans; D008012:Lidocaine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008801:Mexiletine / Q000627:therapeutic use*; D008875:Middle Aged; D013015:Sotalol / Q000627:therapeutic use*; D016677:Tocainide
chemical_list: D000889:Anti-Arrhythmia Agents; D008801:Mexiletine; D016677:Tocainide; D008012:Lidocaine; D013015:Sotalol
vernacular_title: Kombination von Sotalol mit den Klasse-I-B-Substanzen Mexiletin oder Tocainid bei komplexer ventrikulärer Extrasystolie.