Anderson J L, Reid P R, Platia E V, Akhtar M, Ruskin J N, Schaal S F, Jueng P, Long R A, Wenger T L
Am Heart J. 1985 Oct;110(4):774-84. doi: 10.1016/0002-8703(85)90456-9.
Five cardiology centers conducted open-label prospective trials of meobentine sulfate, an intravenously and orally available analog of bethanidine, to assess its potential for treatment of recurrent, drug refractory ventricular tachycardia (VT) or fibrillation (VF), and complex ventricular arrhythmias. The study population comprised 26 patients (mean age, 61 years); 18 were men. Coronary artery disease was present in 15, cardiomyopathy in six, and valvular heart disease in three. Patients presented with both VT and VF (seven), sustained VT alone (12), or frequent ventricular ectopy (PVCs) and nonsustained VT (seven). Of the 26 patients, 5 were enrolled in antiarrhythmic studies (chronic PVC suppression) and 21 were enrolled in programmed electrical stimulation (PES) studies. Two of five in the chronic PVC study showed greater than 75% arrhythmia suppression. Among 21 patients in PES studies, there were eight intravenous (16 mg/kg) and 19 oral trials (400 to 1000 mg every 6 hours, 3 days/dose interval). Five of 22 patients showed efficacy at repeat PES study (neither VT nor VF), one showed partial efficacy, and four were not restudied because of clinical arrhythmia (three) and/or adverse effects (two). Overall, three patients (12%) were continued on the drug for an extended period of time. Adverse experience included hypotension in 50% and gastrointestinal effects (nausea, vomiting, or diarrhea) in 56% (oral trials only). Adverse reactions led to drug discontinuation in six and dosage reduction in eight patients. Thus, meobentine may prevent induction of VT or VF or reduce frequency of complex PVCs in selected patients refractory to other antiarrhythmic agents, but the response rate is relatively low. Symptomatic hypotension or gastrointestinal adverse effects are common and may limit utility of meobentine as a chronic oral antiarrhythmic agent.
五个心脏病学中心对硫酸美奥苯汀进行了开放标签前瞻性试验，硫酸美奥苯汀是苄乙胍的一种可静脉内和口服的类似物，以评估其治疗复发性、药物难治性室性心动过速（VT）或颤动（VF）以及复杂性室性心律失常的潜力。研究人群包括26名患者（平均年龄61岁）；18名为男性。15例患有冠状动脉疾病，6例患有心肌病，3例患有心脏瓣膜病。患者同时出现室性心动过速和室颤（7例）、单纯持续性室性心动过速（12例）或频发室性早搏（PVC）和非持续性室性心动过速（7例）。在这26例患者中，5例参加了抗心律失常研究（慢性PVC抑制），21例参加了程序电刺激（PES）研究。慢性PVC研究中的5例中有2例心律失常抑制率大于75%。在21例PES研究患者中，有8例进行了静脉试验（16mg/kg）和19例口服试验（每6小时400至1000mg，给药间隔3天）。22例患者中有5例在重复PES研究时显示有效（无室性心动过速或室颤），1例显示部分有效，4例因临床心律失常（3例）和/或不良反应（2例）未再次研究。总体而言，3例患者（12%）长期持续使用该药物。不良经历包括50%的患者出现低血压，56%的患者出现胃肠道反应（恶心、呕吐或腹泻，仅口服试验）。不良反应导致6例患者停药，8例患者减量。因此，美奥苯汀可能在对其他抗心律失常药物难治的特定患者中预防室性心动过速或室颤的诱发或降低复杂性室性早搏的频率，但有效率相对较低。症状性低血压或胃肠道不良反应很常见，可能会限制美奥苯汀作为慢性口服抗心律失常药物的应用。
