title: Short- and long-term therapy with tocainide for malignant ventricular tachyarrhythmias.
abstract: Tocainide was administered to 228 patients referred for treatment of recurrent ventricular tachyarrhythmias that were refractory to therapy with conventional antiarrhythmic drugs. After baseline studies, 1200 to 2400 mg tocainide/day was given for 4 days. Tocainide was effective in 49% of 180 patients evaluated with monitoring and exercise testing and in 35% of 48 patients undergoing electrophysiologic testing. No clinical parameter predicted the response to tocainide, although there was a correlation with the effect of lidocaine. Tocainide was selected for long-term treatment in 73 patients who were followed for an average of 26.4 months (range 1 to 92 months). The incidence of sudden death was 4.3% per year and two patients had nonfatal recurrence of arrhythmia. It is concluded that tocainide is effective and well tolerated during long-term use if therapy is evaluated carefully and is individualized.
authors.forename: S H
authors.initials: SH
authors.lastname: Hohnloser
authors.forename: H W
authors.initials: HW
authors.lastname: Lange
authors.forename: E A
authors.initials: EA
authors.lastname: Raeder
authors.forename: P J
authors.initials: PJ
authors.lastname: Podrid
authors.forename: B
authors.initials: B
authors.lastname: Lown
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D003645:Death, Sudden / Q000453:epidemiology; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013610:Tachycardia / Q000188:drug therapy*; D013997:Time Factors; D016677:Tocainide; D014693:Ventricular Fibrillation / Q000188:drug therapy*
chemical_list: D000889:Anti-Arrhythmia Agents; D016677:Tocainide; D008012:Lidocaine