Antiarrhythmic efficacy of penticainide and comparison with disopyramide, flecainide, propafenone and mexiletine by acute oral drug testing.
The antiarrhythmic efficacy of a new class I agent, penticainide, was evaluated by acute oral drug testing and compared in the same patient population with the efficacy of disopyramide, flecainide, mexiletine and propafenone. Twenty-five patients with high-grade chronic ventricular arrhythmias entered the study. During acute oral drug testing, penticainide (7 mg/kg) was effective (more than 90% reduction in ventricular premature complexes and complete abolition of class 4A and 4B arrhythmias) in 17 of 25 subjects (68%). The mean plasma level of the drug at 90 minutes was 4.4 +/- 1.9 micrograms/ml; at the same time increases in the PQ interval (from 168 +/- 27 to 189 +/- 31 ms, p less than 0.0001) and QRS duration (from 89 +/- 14 to 96 +/- 18 ms, p less than 0.001) were observed. The QTc was slightly but not significantly shortened in the overall population; however, in the subgroup with a basally prolonged QTc (n = 8), a significant reduction was observed (from 456 +/- 8 to 440 +/- 18 ms, p less than 0.02). No adverse effects were reported. The antiarrhythmic efficacy of the other drugs tested in the same population was: disopyramide, 12 of 19 (63%); flecainide, 13 of 24 (54%); propafenone, 13 of 24 (54%); and mexiletine, 7 of 20 (35%). Penticainide appears to be a well-tolerated and effective compound of potential value for treatment of ventricular arrhythmias.
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000503:physiopathology; D002908:Chronic Disease; D004206:Disopyramide / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004562:Electrocardiography; D004594:Electrophysiology; D005260:Female; D005424:Flecainide / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008801:Mexiletine / Q000008:administration & dosage; D008875:Middle Aged; D011405:Propafenone / Q000008:administration & dosage; D011437:Propylamines / Q000008:administration & dosage*; D011725:Pyridines
D000889:Anti-Arrhythmia Agents; D011437:Propylamines; D011725:Pyridines; D008801:Mexiletine; C045930:propisomide; D011405:Propafenone; D004206:Disopyramide; D005424:Flecainide