Antiarrhythmic use of cibenzoline, a new class 1 antiarrhythmic agent with class 3 and 4 properties, in patients with recurrent ventricular tachycardia

Abstract

Cibenzoline is a new antiarrhythmic agent with class 1 properties, and additional class 3 and 4 effects. We treated 28 patients with drug-refractory and recurrent ventricular tachycardia with up to 700 mg/day cibenzoline for periods up to 5.5 months. Cibenzoline prevented the recurrence of ventricular tachycardia in five patients (18%). In three patients (11%) the arrhythmia may have been worsened, in 23 patients (82%) cibenzoline was ineffective. Cibenzoline increased the PR interval by 18% and the QRS duration by 33%; the effect on the QT was variable and the corrected QT interval did not change significantly. Side-effects were observed in 21% of patients. We conclude that cibenzoline does not appear to be superior to conventional class 1 antiarrhythmic agents and that it cannot be recommended for general use in patients with ventricular tachycardia. Additional pharmacokinetic and electrophysiologic studies are required before cibenzoline is used in outpatients with severe ventricular arrhythmias.

Oral cibenzoline reduces postoperative atrial fibrillation in coronary artery bypass grafting

“…The trough level of the plasma concentration of cibenzoline is considered to be 25-250/xg/mL. 16 In the present study, we consider that adequate plasma concentration of cibenzoline was achieved even via gastric tube administration, and the effective plasma concentration was achieved almost within the first 24 hours. After starting normal oral administration, the effective plasma concentration was also achieved.…”

Cibenzoline

“…During chronic therapy with cibenzoline (260-700 mg/day p.0.). it has been reported that the PR interval or the AH interval increased by about 15% (5,6,10,27,47,48). Indeed, Kostis et al (29) reported that the extent of these increases in PR interval was directly proportional to the plasma concentration of cibenzoline.…”

“…(4 mg/kg) or p .~. (7 or 14 mgkg per day for [8][9][10][11][12][13][14][15][16] days), had little or no effect on AH conduction time in the in situ canine heart.…”

“…The duration of the HV interval has been reported to increase after acute (54) or chronic treatment (5,6,30,47) with cibenzoline. Also, the QRS duration repeatedly has been observed to increase after cibenzoline administration: these increases occur after either acute (39,41,55) or chronic (5,6,10,27,30,47,48) therapy. In most of these studies, the increases in QRS duration have ranged from 14 to 17% over control values.…”

“…Chronic cibenzoline therapy has been reported to exert little or no effect on QT interval in several studies (5,6,10,27,30), but other studies have indicated that QT duration increases following acute (39,4134) or chronic (29,47,48) therapy with the drug.…”