Klinische Erfahrungen mit dem neuen Antiarrhythmikum Aprindin anhand von Langzeit-Trendanalysen

Abstract

The therapeutic effectiveness of aprindine (Amidonal) was evaluated by trend analyses in 25 patients with predominantly severe forms of ventricular extrasystoles. The arrhythmia was stopped or improved in most instances. Severe side-effects for which the drug had to be discontinued occurred in three patients. The drug has a long half-life (about 20-30 hours). As a result, there can be cumulative dose-dependent side-effects, largely of a CNS type, disappearing after the dose has been reduced. Thirteen patients continued to be treated on an ambulatory basis, the oral maintenance dose averaging 100 mg/d, the mean follow-up period 11 1/2 months. There was no evidence of side-effects on liver, electrolytes, renal function or blood.

QT-Interval prolonging drugs: Mechanisms and clinical relevance of their arrhythmogenic hazards

“…APD is reduced by a decrease in the tetrodotoxin-sensitive inward sodium current during the plateau phase of the AP. Aprindine lengthens ERP significantly in atrium and ventricle [195,239], which results in a significant QT prolongation and the occurrence of torsades de pointes [65,193,216]. Scagliotti [193] reported on five patients with torsades de pointes; their QT interval was >0.55 seconds and proarrhythmia was common with previous proarrhythmia during treatment with quinidine, disopyramide, or procainamide.…”