[Significance of cardiac arrhythmias in the aged and their treatment with propafenone controlled by plasma level].

Every form of cardiac arrhythmia can complicate the existing cardiovascular and cerebrovascular changes in elderly people. A controlled clinical study was performed on 37 geriatric patients, aged 45-93 years (average 77.3 years), with supraventricular and ventricular premature beats (SVPB, VPB). The effect of propafenon on premature beats was tested in a 24-hour ECG monitoring: propafenon has a significant reducing influence on SVPB and VPB in elderly patients. More than 50% of all patients had these results with a daily dosage of 2 X 150 mg. In 40% the dosage had to be increased to 2 X 300 mg. There was a negative correlation between plasma levels and number of arrhythmias, i.e. high plasma levels were connected with lower arrhythmias. No laboratory findings were changed, no side effects were observed. Contrary to much higher doses in other studies the good results of our small doses can be explained by the different pharmacokinetics of old age. Bearing this fact in mind, propafenon can be valuable in the treatment of arrhythmias even in older patients.