Key result
Desipramine reduced ventricular ectopic depolarization frequency by ≥75% in 4 of 7 patients, but frequent adverse effects necessitated drug discontinuation or dose reduction in 5 patients.
Why the study?
Does desipramine reduce the frequency of chronic ventricular ectopic depolarizations in patients with frequent VEDs?
RCT (n=10)
Single-blind
Does desipramine reduce the frequency of chronic ventricular ectopic depolarizations in patients with frequent VEDs?
Answers are grounded in this paper and cite their sources.
While desipramine effectively suppresses chronic ventricular ectopy, its clinical utility is severely limited by frequent adverse effects requiring dose reduction or discontinuation.
The effect of desipramine on chronic ventricular ectopic depolarizations (VEDs) was studied in 10 patients with at least 30 VEDs per hour. A single-blind, placebo-controlled, dose-ranging protocol was followed. Efficacy was defined as a decrease in VED frequency of at least 75%, base on three 24 hour ambulatory ECGs obtained on each dose. Among seven patients with analyzable data, one responded to 75 mg daily, and three others responded to 150 mg daily. Six of the seven patients demonstrated decreases in VED frequency with increases in desipramine serum concentration. Among five patients with episodes of nonsustained ventricular tachycardia, desipramine completely abolished the episodes in two, and reduced the frequency of episodes by at least 90% in two others. Adverse reactions were common, and necessitated drug discontinuation or dose reduction in five patients. Desipramine has an antiarrhythmic effect in patients with chronic ventricular ectopy, but its clinical utility is limited by adverse effects.
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Fenster et al. (1989) conducted an RCT in Chronic ventricular ectopic depolarizations (VEDs) (n=10). Desipramine vs. Placebo was evaluated on Decrease in VED frequency of at least 75%. Desipramine reduced ventricular ectopic depolarization frequency by ≥75% in 4 of 7 patients, but frequent adverse effects necessitated drug discontinuation or dose reduction in 5 patients.
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