Why the study?
Does oral tocainide improve refractory ventricular dysrhythmia in affected patients?
Does oral tocainide improve refractory ventricular dysrhythmia in affected patients?
Oral tocainide shows preliminary efficacy for refractory ventricular dysrhythmia but carries significant safety concerns, particularly sudden death in patients with concurrent left ventricular dysfunction.
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Tocainide may support initial use in lidocaine-sensitive cases but signals sudden death risk in LV dysfunction; hypothesis-generating and should not change practice.
The preliminary data on efficacy and safety of oral tocainide in refractory ventricular dysrhythmia in 8 patients is described. Two patients died; one within 15 days and the other after 1750 days of continuous tocainide therapy. The cause of death in both patients was unclear. During initial administration and acute titration, oral tocainide was extremely effective in lidocaine-sensitive ventricular dysrhythmia and in patients with Q-T prolongation syndrome. Four out of 8 patients received tocainide in presence of left ventricular dysfunction and 2 out of 4 such patients died suddenly. Minor central nervous system side effects were seen in 2 patients and dermatologic adverse reaction was seen in one patient only.
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Mahapatra et al. (1986) studied this question.
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