Antiarrhythmic Drug Therapy for Suppression of Ventricular Arrhythmia: Experience with 122 Patients Treated for Two Years

Although there are many reports of the short‐term effectiveness of antiarrhythmic drugs for suppression of ventricular ectopic depolarizations, there are less data available on the long‐term use of these drugs. We treated 122 patients for up to 2 years with antiarrhythmic drugs for suppression of frequent ventricular ectopic depolarizations. The percent suppression of ventricular ectopic depolarizations and nonsustained ventricular tachycardia for each drug was determined at 1, 3, 6, 12, 18, and 24 months of therapy. Among 33 patients treated with flecainide, the mean suppression of ventricular ectopic depolarizations (average of all data during 24 months) was 93 ± 17% and of nonsustained ventricular tachycardia was 97 ± 7%. In 27 patients treated with encainide, the mean suppression of ventricular ectopic depolarizations was 88 ± 18% and of ventricular tachycardia was 95 ± 16%. Among 26 patients treated with propafenone, the mean suppression of ventricular ectopic depolarizations was 77 ± 32% and of ventricular tachycardia was 93 ± 15%. For the 20 patients treated with moricizine, the mean suppression of ventricular ectopic depolarizations was 62 ± 35% and of ventricular tachycardia was 90 ± 14%. Among 16 patients treated with amiodarone, the mean suppression of ventricular ectopic depolarizations was 92 ± 14% and of nonsustained ventricular tachycardia was 99 ± 3%. In 54 of the 122 patients (44%), the study drug was stopped during 2 years of therapy because of death (2 sudden, 2 unwitnessed and 6 noncardiac), side effects (21 patients), lack or of loss of efficacy (13 patients), and noncompliance (10 patients). Thus, it is possible to maintain effective suppression of ventricular ectopic depolarizations and nonsustained ventricular tachycardia in patients for up to 2 years, but the rate of withdrawal from therapy is substantial. 1990 American College of Clinical Pharmacology