title: Combination of disopyramide and mexiletine for better tolerance and additive effects for treatment of ventricular arrhythmias.
abstract: The efficacy and tolerance of disopyramide and mexiletine used alone and in combination were studied in 21 patients with frequent (greater than or equal to 30/h) ventricular premature complexes. Ambulatory electrocardiographic monitoring was performed at baseline and during therapy with disopyramide alone, mexiletine alone and a combination of disopyramide and mexiletine. During single drug therapy, the dose of disopyramide was 602 +/- 152 mg/day and that of mexiletine was 738 +/- 144 mg/day. During combination therapy with smaller doses of disopyramide (524 +/- 134 mg/day) and mexiletine (652 +/- 146 mg/day), no patient had side effects. At baseline before therapy, the mean number of ventricular premature complexes per hour, was 608 +/- 757, of couplets per hour was 22.4 +/- 45.8 and of episodes of nonsustained ventricular tachycardia/24 h was 219.7 +/- 758.2. The mean number of ventricular premature complexes per hour was reduced to 156 +/- 217 with disopyramide alone, 188 +/- 298 with mexiletine alone and 76 +/- 144 with combination therapy (p less than 0.05 for combination therapy versus disopyramide or mexiletine alone; p = NS for disopyramide versus mexiletine). Individually, an effective regimen (greater than 83% reduction in ventricular premature complexes and abolition of nonsustained ventricular tachycardia) was found in 5 (24%) of 21 patients during therapy with disopyramide alone, in 3 (14%) receiving mexiletine alone and in 13 (62%) receiving combination therapy (p less than 0.05 for combination therapy versus disopyramide or mexiletine; p = NS for disopyramide versus mexiletine). Thus, the antiarrhythmic effects of disopyramide and mexiletine are additive.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Medicine, Montefiore Medical Center-Montefiore Hospital, Bronx, New York 10467.
authors.forename: S G
authors.initials: SG
authors.lastname: Kim
authors.forename: A D
authors.initials: AD
authors.lastname: Mercando
authors.forename: S
authors.initials: S
authors.lastname: Tam
authors.forename: J D
authors.initials: JD
authors.lastname: Fisher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000188:drug therapy*; D004206:Disopyramide / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008801:Mexiletine / Q000008:administration & dosage*; D008875:Middle Aged; D008991:Monitoring, Physiologic; D013610:Tachycardia / Q000188:drug therapy
chemical_list: D008801:Mexiletine; D004206:Disopyramide