Lidocaine, mexiletine and propafenone in the treatment of arrhythmias complicating myocardial infarction. A case report.
We describe a case of acute myocardial infarction complicated by atrial and ventricular arrhythmias in which it was possible to verify the effectiveness of lidocaine, mexiletine and propafenone. Intravenous administration of mexiletine was ineffective both on atrial and ventricular rhythm disturbances. The lidocaine therapy reduced ventricular ectopic frequency, but did not prevent the appearance of several paroxysms of atrial fibrillation. Intravenous infusion of propafenone, 11 micrograms/kg per min, after a 1 mg/kg i.v. bolus, immediately and completely suppressed atrial arrhythmias. The increase in infusion rate up to 22 micrograms/kg per min also suppressed ventricular ectopy. This dosage of propafenone did not provoke serious adverse effects in our patient.
Aguglia
F
F
Gnecchi
M
M
De Marzio
P
P
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy*; D001281:Atrial Fibrillation / Q000188:drug therapy; D005117:Cardiac Complexes, Premature / Q000188:drug therapy; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D006325:Heart Atria / Q000187:drug effects; D006352:Heart Ventricles / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008801:Mexiletine / Q000627:therapeutic use*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D011405:Propafenone; D011427:Propiophenones / Q000627:therapeutic use*; D011437:Propylamines / Q000627:therapeutic use*; D013610:Tachycardia / Q000188:drug therapy
D000889:Anti-Arrhythmia Agents; D011427:Propiophenones; D011437:Propylamines; D008801:Mexiletine; D011405:Propafenone; D008012:Lidocaine