title: Crossover comparison of cibenzoline and quinidine in ambulatory patients with chronic ventricular arrhythmias.
abstract: This study was designed to compare the efficacy and safety of cibenzoline and quinidine in ambulatory patients with ventricular arrhythmias. Following washout of previous antiarrhythmic treatment, a 48-h ambulatory electrocardiographic (ECG) recording was obtained. Twenty-seven patients were screened, of whom 20 met the entry criteria of greater than or equal to 30 ventricular premature beats (VPBs)/h. Cibenzoline was started at 130 mg every 12 h and was increased to 160 mg every 12 h if necessary. Quinidine was started at 300 mg every 6 h and was increased to 400 mg every 6 h if necessary. Treatment was assessed by 24-h ambulatory ECG recording. Efficacy was defined as greater than 75% reduction in single VPBs, greater than 90% reduction in paired VPBs, and total abolition of ventricular tachycardia events. A 7-day washout with repeat 24-h ambulatory ECG recording to document return of ventricular arrhythmias was required prior to crossover. Efficacy was documented in 9 of 20 (45%) patients receiving cibenzoline and in 9 of 20 (45%) patients receiving quinidine. Response to cibenzoline 130 mg every 12 h was documented in 8 of 20 (40%) patients and in 1 of 11 (9%) patients receiving cibenzoline 160 mg every 12 h. Response to quinidine 300 mg every 6 h was documented in 8 of 20 (40%) patients and in 2 of 6 (33%) patients receiving 400 mg every 6 h. Dose-limiting side effects occurred in 1 of 20 (5%) patients receiving cibenzoline and in 7 of 20 (35%) patients receiving quinidine. Cibenzoline and quinidine are equal in efficacy, but cibenzoline is significantly better tolerated.
authors: Drug Evaluation Unit, Creighton University School of Medicine, Omaha, Nebraska 68131.
authors: S M
authors: SM
authors: Mohiuddin
authors: M P
authors: MP
authors: Woodruff
authors: D J
authors: DJ
authors: Esterbrooks
authors: A N
authors: AN
authors: Mooss
authors: J M
authors: JM
authors: Hansen
authors: D E
authors: DE
authors: Hilleman
mesh_terms: D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy*; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011802:Quinidine / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D011897:Random Allocation
chemical_list: D000889:Anti-Arrhythmia Agents; D007093:Imidazoles; D011802:Quinidine; C032151:cifenline