[Early interruption of antiarrhythmia treatment in the acute phase of infarction complicated by ventricular arrhythmia].
18 patients with myocardial infarction complicated by severe ventricular arrhythmias (polymorphic VEBs or bigeminy = 5; VT = 11; VF = 2) were treated with antiarrhythmics which were stopped after 24 hours (intravenous infusion of mexiletine 0.5 mg/kg/hr after a loading dose). This treatment resulted in one failure (recurrent VF) and 17 successes, after increasing the dose in 3 cases of VT. After stopping treatment, 72% of patients had no further arrhythmia. 5 cases had recurrent VT within 72 hours, which was controlled by oral mexiletine in 4 cases. The ejection fraction was significantly decreased in the group with recurrent VT. Plasma assays were of little help. Stopping the antiarrhythmic treatment after 24 hours does not therefore present any particular risks and can be proposed even in cases with severe arrhythmias.
D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000209:etiology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008801:Mexiletine / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy*; D011437:Propylamines / Q000627:therapeutic use*; D012008:Recurrence
D011437:Propylamines; D008801:Mexiletine
Interruption précoce du traitement antiarythmique à la phase aiguë des infarctus compliqués de troubles du rythme ventriculaire.