Effects of tocainide studied with programmed electrical stimulation of the heart in patients with reentrant tachyarrhythmias
Identifieur interne : 000F62 ( Main/Corpus ); précédent : 000F61; suivant : 000F63Effects of tocainide studied with programmed electrical stimulation of the heart in patients with reentrant tachyarrhythmias
Auteurs : André Waleffe ; Patrick Bruninx ; Luc Mary-Rabine ; Henri E. KulbertusSource :
- The American Journal of Cardiology [ 0002-9149 ] ; 1979.
Abstract
The electrophysiologic effects of tocainide were studied with programmed electrical stimulation of the heart in two patients with atrioventricular (A-V) nodal tachycardia, five patients with reentrant tachycardia involving an accessory pathway and two patients with paroxysmal ventricular tachycardia. The measurements were made before and after a 15 minute perfusion of tocainide at a dose of 0.75 mg/kg per min in the first seven patients and of 0.5 mg/kg per min in the last two. At the end of perfusion, the drug plasma level ranged from 2.0 to 10.2 μg/ml (mean 6). During the subsequent 60 minutes, the plasma level decreased extremely slowly, its mean value remaining constantly between 3 and 4 μg/ml. Tocainide failed to achieve statistically significant effects on the functional properties of the A-V node. However, an increase of A-H time (two patients), prolongation of nodal refractory period (one patient) and lengthening of the cycle length producing a second degree A-V block (four patients) were observed in isolated cases. The H-V interval increased by 20 msec in three of the eight cases in which its measurement was not hampered by the constant presence of a preexcitation wave. No systematic effect on the refractory periods of the atrial and ventricular muscle was noted. In six patients, tocainide was perfused during sustained episodes of tachycardia (A-V nodal tachycardia, two patients; circus movement tachycardia using an accessory pathway, three patients; and paroxysmal ventricular tachycardia, one patient). Sinus rhythm was restored in all six patients. The drug prevented reinitiation of tachycardia in four of the eight patients in whom it could easily be triggered during the control period; it lengthened the tachycardia cycle length in the remaining four. No side effects were noted. These results, obtained with low plasma levels of tocainide, allow one to consider this drug a promising antiarrhythmic agent.
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DOI: 10.1016/S0002-9149(79)80018-1
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effects of tocainide studied with programmed electrical stimulation of the heart in patients with reentrant tachyarrhythmias</title><author><name sortKey="Waleffe, Andre" sort="Waleffe, Andre" uniqKey="Waleffe A" first="André" last="Waleffe">André Waleffe</name><affiliation><mods:affiliation>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</mods:affiliation></affiliation></author><author><name sortKey="Bruninx, Patrick" sort="Bruninx, Patrick" uniqKey="Bruninx P" first="Patrick" last="Bruninx">Patrick Bruninx</name><affiliation><mods:affiliation>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</mods:affiliation></affiliation></author><author><name sortKey="Mary Rabine, Luc" sort="Mary Rabine, Luc" uniqKey="Mary Rabine L" first="Luc" last="Mary-Rabine">Luc Mary-Rabine</name><affiliation><mods:affiliation>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</mods:affiliation></affiliation></author><author><name sortKey="Kulbertus, Henri E" sort="Kulbertus, Henri E" uniqKey="Kulbertus H" first="Henri E." last="Kulbertus">Henri E. Kulbertus</name><affiliation><mods:affiliation>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:C1DB2349E090FFFAB63418E6D6E4DC12FB563F4C</idno><date when="1979" year="1979">1979</date><idno type="doi">10.1016/S0002-9149(79)80018-1</idno><idno type="url">https://api.istex.fr/document/C1DB2349E090FFFAB63418E6D6E4DC12FB563F4C/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000F62</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="ISTEX">000F62</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Effects of tocainide studied with programmed electrical stimulation of the heart in patients with reentrant tachyarrhythmias</title><author><name sortKey="Waleffe, Andre" sort="Waleffe, Andre" uniqKey="Waleffe A" first="André" last="Waleffe">André Waleffe</name><affiliation><mods:affiliation>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</mods:affiliation></affiliation></author><author><name sortKey="Bruninx, Patrick" sort="Bruninx, Patrick" uniqKey="Bruninx P" first="Patrick" last="Bruninx">Patrick Bruninx</name><affiliation><mods:affiliation>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</mods:affiliation></affiliation></author><author><name sortKey="Mary Rabine, Luc" sort="Mary Rabine, Luc" uniqKey="Mary Rabine L" first="Luc" last="Mary-Rabine">Luc Mary-Rabine</name><affiliation><mods:affiliation>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</mods:affiliation></affiliation></author><author><name sortKey="Kulbertus, Henri E" sort="Kulbertus, Henri E" uniqKey="Kulbertus H" first="Henri E." last="Kulbertus">Henri E. Kulbertus</name><affiliation><mods:affiliation>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="ISSN">0002-9149</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1979">1979</date><biblScope unit="vol">43</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="292">292</biblScope><biblScope unit="page" to="299">299</biblScope></imprint><idno type="ISSN">0002-9149</idno></series><idno type="istex">C1DB2349E090FFFAB63418E6D6E4DC12FB563F4C</idno><idno type="DOI">10.1016/S0002-9149(79)80018-1</idno><idno type="PII">S0002-9149(79)80018-1</idno><idno type="ArticleID">79800181</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-9149</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The electrophysiologic effects of tocainide were studied with programmed electrical stimulation of the heart in two patients with atrioventricular (A-V) nodal tachycardia, five patients with reentrant tachycardia involving an accessory pathway and two patients with paroxysmal ventricular tachycardia. The measurements were made before and after a 15 minute perfusion of tocainide at a dose of 0.75 mg/kg per min in the first seven patients and of 0.5 mg/kg per min in the last two. At the end of perfusion, the drug plasma level ranged from 2.0 to 10.2 μg/ml (mean 6). During the subsequent 60 minutes, the plasma level decreased extremely slowly, its mean value remaining constantly between 3 and 4 μg/ml. Tocainide failed to achieve statistically significant effects on the functional properties of the A-V node. However, an increase of A-H time (two patients), prolongation of nodal refractory period (one patient) and lengthening of the cycle length producing a second degree A-V block (four patients) were observed in isolated cases. The H-V interval increased by 20 msec in three of the eight cases in which its measurement was not hampered by the constant presence of a preexcitation wave. No systematic effect on the refractory periods of the atrial and ventricular muscle was noted. In six patients, tocainide was perfused during sustained episodes of tachycardia (A-V nodal tachycardia, two patients; circus movement tachycardia using an accessory pathway, three patients; and paroxysmal ventricular tachycardia, one patient). Sinus rhythm was restored in all six patients. The drug prevented reinitiation of tachycardia in four of the eight patients in whom it could easily be triggered during the control period; it lengthened the tachycardia cycle length in the remaining four. No side effects were noted. These results, obtained with low plasma levels of tocainide, allow one to consider this drug a promising antiarrhythmic agent. </div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>André Waleffe MD</name><affiliations><json:string>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</json:string></affiliations></json:item><json:item><name>Patrick Bruninx MD</name><affiliations><json:string>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</json:string></affiliations></json:item><json:item><name>Luc Mary-Rabine MD</name><affiliations><json:string>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</json:string></affiliations></json:item><json:item><name>Henri E. Kulbertus MD, FACC</name><affiliations><json:string>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</json:string></affiliations></json:item></author><language><json:string>eng</json:string></language><abstract>The electrophysiologic effects of tocainide were studied with programmed electrical stimulation of the heart in two patients with atrioventricular (A-V) nodal tachycardia, five patients with reentrant tachycardia involving an accessory pathway and two patients with paroxysmal ventricular tachycardia. The measurements were made before and after a 15 minute perfusion of tocainide at a dose of 0.75 mg/kg per min in the first seven patients and of 0.5 mg/kg per min in the last two. At the end of perfusion, the drug plasma level ranged from 2.0 to 10.2 μg/ml (mean 6). During the subsequent 60 minutes, the plasma level decreased extremely slowly, its mean value remaining constantly between 3 and 4 μg/ml. Tocainide failed to achieve statistically significant effects on the functional properties of the A-V node. However, an increase of A-H time (two patients), prolongation of nodal refractory period (one patient) and lengthening of the cycle length producing a second degree A-V block (four patients) were observed in isolated cases. The H-V interval increased by 20 msec in three of the eight cases in which its measurement was not hampered by the constant presence of a preexcitation wave. No systematic effect on the refractory periods of the atrial and ventricular muscle was noted. In six patients, tocainide was perfused during sustained episodes of tachycardia (A-V nodal tachycardia, two patients; circus movement tachycardia using an accessory pathway, three patients; and paroxysmal ventricular tachycardia, one patient). Sinus rhythm was restored in all six patients. The drug prevented reinitiation of tachycardia in four of the eight patients in whom it could easily be triggered during the control period; it lengthened the tachycardia cycle length in the remaining four. No side effects were noted. These results, obtained with low plasma levels of tocainide, allow one to consider this drug a promising antiarrhythmic agent.</abstract><qualityIndicators><score>7.764</score><pdfVersion>1.3</pdfVersion><pdfPageSize>634 x 864 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1947</abstractCharCount><pdfWordCount>4764</pdfWordCount><pdfCharCount>28224</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>300 </abstractWordCount></qualityIndicators><title>Effects of tocainide studied with programmed electrical stimulation of the heart in patients with reentrant tachyarrhythmias</title><pii><json:string>S0002-9149(79)80018-1</json:string></pii><genre></genre><serie><volume>52</volume><pages><last>741</last><first>731</first></pages><genre><json:string>Book</json:string></genre><language><json:string>unknown</json:string></language><title>Mayo Clin Proc</title></serie><host><volume>43</volume><pii><json:string>S0002-9149(79)X8001-0</json:string></pii><pages><last>299</last><first>292</first></pages><issn><json:string>0002-9149</json:string></issn><issue>2</issue><genre></genre><language><json:string>unknown</json:string></language><title>The American Journal of Cardiology</title><publicationDate>1979</publicationDate></host><categories><wos><json:string>CARDIAC & CARDIOVASCULAR SYSTEMS</json:string></wos></categories><publicationDate>1979</publicationDate><copyrightDate>1979</copyrightDate><doi><json:string>10.1016/S0002-9149(79)80018-1</json:string></doi><id>C1DB2349E090FFFAB63418E6D6E4DC12FB563F4C</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/C1DB2349E090FFFAB63418E6D6E4DC12FB563F4C/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/C1DB2349E090FFFAB63418E6D6E4DC12FB563F4C/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/C1DB2349E090FFFAB63418E6D6E4DC12FB563F4C/fulltext/tei"><teiHeader type="text"><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Effects of tocainide studied with programmed electrical stimulation of the heart in patients with reentrant tachyarrhythmias</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><date>1979</date></publicationStmt><notesStmt><note type="content">Section title: Report On Therapy</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Effects of tocainide studied with programmed electrical stimulation of the heart in patients with reentrant tachyarrhythmias</title><author><persName><forename type="first">André</forename><surname>Waleffe</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</affiliation></author><author><persName><forename type="first">Patrick</forename><surname>Bruninx</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</affiliation></author><author><persName><forename type="first">Luc</forename><surname>Mary-Rabine</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</affiliation></author><author><persName><forename type="first">Henri E.</forename><surname>Kulbertus</surname></persName><roleName type="degree">MD, FACC</roleName><note type="biography">Address for reprints: H. E. Kulbertus, MD, Division of Cardiology, Institute of Medicine, 66 Bvd de la Constitution, B 4020 Liège, Belgium.</note><affiliation>Address for reprints: H. E. Kulbertus, MD, Division of Cardiology, Institute of Medicine, 66 Bvd de la Constitution, B 4020 Liège, Belgium.</affiliation><affiliation>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</affiliation></author></analytic><monogr><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="pISSN">0002-9149</idno><idno type="PII">S0002-9149(79)X8001-0</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1979"></date><biblScope unit="vol">43</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="292">292</biblScope><biblScope unit="page" to="299">299</biblScope></imprint></monogr><idno type="istex">C1DB2349E090FFFAB63418E6D6E4DC12FB563F4C</idno><idno type="DOI">10.1016/S0002-9149(79)80018-1</idno><idno type="PII">S0002-9149(79)80018-1</idno><idno type="ArticleID">79800181</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1979</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>The electrophysiologic effects of tocainide were studied with programmed electrical stimulation of the heart in two patients with atrioventricular (A-V) nodal tachycardia, five patients with reentrant tachycardia involving an accessory pathway and two patients with paroxysmal ventricular tachycardia. The measurements were made before and after a 15 minute perfusion of tocainide at a dose of 0.75 mg/kg per min in the first seven patients and of 0.5 mg/kg per min in the last two. At the end of perfusion, the drug plasma level ranged from 2.0 to 10.2 μg/ml (mean 6). During the subsequent 60 minutes, the plasma level decreased extremely slowly, its mean value remaining constantly between 3 and 4 μg/ml. Tocainide failed to achieve statistically significant effects on the functional properties of the A-V node. However, an increase of A-H time (two patients), prolongation of nodal refractory period (one patient) and lengthening of the cycle length producing a second degree A-V block (four patients) were observed in isolated cases. The H-V interval increased by 20 msec in three of the eight cases in which its measurement was not hampered by the constant presence of a preexcitation wave. No systematic effect on the refractory periods of the atrial and ventricular muscle was noted. In six patients, tocainide was perfused during sustained episodes of tachycardia (A-V nodal tachycardia, two patients; circus movement tachycardia using an accessory pathway, three patients; and paroxysmal ventricular tachycardia, one patient). Sinus rhythm was restored in all six patients. The drug prevented reinitiation of tachycardia in four of the eight patients in whom it could easily be triggered during the control period; it lengthened the tachycardia cycle length in the remaining four. No side effects were noted. These results, obtained with low plasma levels of tocainide, allow one to consider this drug a promising antiarrhythmic agent.</p></abstract></profileDesc><revisionDesc><change when="1978-07-11">Received</change><change when="1978-09-20">Registration</change><change when="1978-09-19">Modified</change><change when="1979">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/C1DB2349E090FFFAB63418E6D6E4DC12FB563F4C/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier doc found" wicri:toSee="Elsevier, no converted or simple article"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 5.0.1//EN//XML" URI="art501.dtd" name="istex:docType"></istex:docType><istex:document><article version="5.0" xml:lang="en" docsubtype="fla"><item-info><jid>AJC</jid><aid>79800181</aid><ce:pii>S0002-9149(79)80018-1</ce:pii><ce:doi>10.1016/S0002-9149(79)80018-1</ce:doi><ce:copyright type="unknown" year="1979"></ce:copyright></item-info><head><ce:dochead><ce:textfn>Report On Therapy</ce:textfn></ce:dochead><ce:title>Effects of tocainide studied with programmed electrical stimulation of the heart in patients with reentrant tachyarrhythmias</ce:title><ce:author-group><ce:author><ce:degrees>MD</ce:degrees><ce:given-name>André</ce:given-name><ce:surname>Waleffe</ce:surname></ce:author><ce:author><ce:degrees>MD</ce:degrees><ce:given-name>Patrick</ce:given-name><ce:surname>Bruninx</ce:surname></ce:author><ce:author><ce:degrees>MD</ce:degrees><ce:given-name>Luc</ce:given-name><ce:surname>Mary-Rabine</ce:surname></ce:author><ce:author><ce:degrees>MD, FACC</ce:degrees><ce:given-name>Henri E.</ce:given-name><ce:surname>Kulbertus</ce:surname><ce:cross-ref refid="cor1"><ce:sup loc="post">1</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="aff1"><ce:textfn>From the Laboratory of Electrocardiology, Division of Cardiology, Institute of Medicine, University of Liège School of Medicine, Liège, Belgium</ce:textfn></ce:affiliation><ce:correspondence id="cor1"><ce:label>1</ce:label><ce:text>Address for reprints: H. E. Kulbertus, MD, Division of Cardiology, Institute of Medicine, 66 Bvd de la Constitution, B 4020 Liège, Belgium.</ce:text></ce:correspondence></ce:author-group><ce:date-received day="11" month="7" year="1978"></ce:date-received><ce:date-revised day="19" month="9" year="1978"></ce:date-revised><ce:date-accepted day="20" month="9" year="1978"></ce:date-accepted><ce:abstract id="ab1" class="author" xml:lang="en"><ce:abstract-sec><ce:simple-para view="all" id="simple-para.0010">The electrophysiologic effects of tocainide were studied with programmed electrical stimulation of the heart in two patients with atrioventricular (A-V) nodal tachycardia, five patients with reentrant tachycardia involving an accessory pathway and two patients with paroxysmal ventricular tachycardia. The measurements were made before and after a 15 minute perfusion of tocainide at a dose of 0.75 mg/kg per min in the first seven patients and of 0.5 mg/kg per min in the last two. At the end of perfusion, the drug plasma level ranged from 2.0 to 10.2 μg/ml (mean 6). During the subsequent 60 minutes, the plasma level decreased extremely slowly, its mean value remaining constantly between 3 and 4 μg/ml.</ce:simple-para><ce:simple-para view="all" id="simple-para.0015">Tocainide failed to achieve statistically significant effects on the functional properties of the A-V node. However, an increase of A-H time (two patients), prolongation of nodal refractory period (one patient) and lengthening of the cycle length producing a second degree A-V block (four patients) were observed in isolated cases. The H-V interval increased by 20 msec in three of the eight cases in which its measurement was not hampered by the constant presence of a preexcitation wave. No systematic effect on the refractory periods of the atrial and ventricular muscle was noted.</ce:simple-para><ce:simple-para view="all" id="simple-para.0020">In six patients, tocainide was perfused during sustained episodes of tachycardia (A-V nodal tachycardia, two patients; circus movement tachycardia using an accessory pathway, three patients; and paroxysmal ventricular tachycardia, one patient). Sinus rhythm was restored in all six patients. The drug prevented reinitiation of tachycardia in four of the eight patients in whom it could easily be triggered during the control period; it lengthened the tachycardia cycle length in the remaining four. No side effects were noted. These results, obtained with low plasma levels of tocainide, allow one to consider this drug a promising antiarrhythmic agent.</ce:simple-para></ce:abstract-sec></ce:abstract></head><tail view="all"><ce:bibliography view="all" id="bibliography.0010"><ce:section-title>References</ce:section-title><ce:bibliography-sec id="bibliography-sec.0010"><ce:bib-reference id="bib1"><ce:label>1.</ce:label><sb:reference><sb:contribution langtype="en"><sb:authors><sb:author><ce:surname>Coltart</ce:surname><ce:given-name>DJ</ce:given-name></sb:author><sb:author><ce:surname>Bernd</ce:surname><ce:given-name>TB</ce:given-name></sb:author><sb:author><ce:surname>Kernoff</ce:surname><ce:given-name>R</ce:given-name></sb:author><sb:author><ce:surname>Harrison</ce:surname><ce:given-name>DC</ce:given-name></sb:author></sb:authors><sb:title><sb:maintitle>Antiarrhythmic and circulating effects of Astra W 36095, a new lidocaine-like 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E. Kulbertus, MD, Division of Cardiology, Institute of Medicine, 66 Bvd de la Constitution, B 4020 Liège, Belgium.</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1979</dateIssued><dateCaptured encoding="w3cdtf">1978-07-11</dateCaptured><dateValid encoding="w3cdtf">1978-09-20</dateValid><dateModified encoding="w3cdtf">1978-09-19</dateModified><copyrightDate encoding="w3cdtf">1979</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">The electrophysiologic effects of tocainide were studied with programmed electrical stimulation of the heart in two patients with atrioventricular (A-V) nodal tachycardia, five patients with reentrant tachycardia involving an accessory pathway and two patients with paroxysmal ventricular tachycardia. The measurements were made before and after a 15 minute perfusion of tocainide at a dose of 0.75 mg/kg per min in the first seven patients and of 0.5 mg/kg per min in the last two. At the end of perfusion, the drug plasma level ranged from 2.0 to 10.2 μg/ml (mean 6). During the subsequent 60 minutes, the plasma level decreased extremely slowly, its mean value remaining constantly between 3 and 4 μg/ml. Tocainide failed to achieve statistically significant effects on the functional properties of the A-V node. However, an increase of A-H time (two patients), prolongation of nodal refractory period (one patient) and lengthening of the cycle length producing a second degree A-V block (four patients) were observed in isolated cases. The H-V interval increased by 20 msec in three of the eight cases in which its measurement was not hampered by the constant presence of a preexcitation wave. No systematic effect on the refractory periods of the atrial and ventricular muscle was noted. In six patients, tocainide was perfused during sustained episodes of tachycardia (A-V nodal tachycardia, two patients; circus movement tachycardia using an accessory pathway, three patients; and paroxysmal ventricular tachycardia, one patient). Sinus rhythm was restored in all six patients. The drug prevented reinitiation of tachycardia in four of the eight patients in whom it could easily be triggered during the control period; it lengthened the tachycardia cycle length in the remaining four. No side effects were noted. These results, obtained with low plasma levels of tocainide, allow one to consider this drug a promising antiarrhythmic agent. </abstract><note type="content">Section title: Report On Therapy</note><relatedItem type="host"><titleInfo><title>The American Journal of Cardiology</title></titleInfo><titleInfo type="abbreviated"><title>AJC</title></titleInfo><originInfo><dateIssued encoding="w3cdtf">197902</dateIssued></originInfo><identifier type="ISSN">0002-9149</identifier><identifier type="PII">S0002-9149(79)X8001-0</identifier><part><date>1979</date><detail type="volume"><number>43</number><caption>vol.</caption></detail><detail type="issue"><number>2</number><caption>no.</caption></detail><extent unit="issue pages"><start>171</start><end>464</end></extent><extent unit="pages"><start>292</start><end>299</end></extent></part></relatedItem><identifier type="istex">C1DB2349E090FFFAB63418E6D6E4DC12FB563F4C</identifier><identifier type="DOI">10.1016/S0002-9149(79)80018-1</identifier><identifier type="PII">S0002-9149(79)80018-1</identifier><identifier type="ArticleID">79800181</identifier><recordInfo><recordOrigin>ELSEVIER</recordOrigin></recordInfo></mods></metadata></istex></record>Pour manipuler ce document sous Unix (Dilib)
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