Tocainide for refractory ventricular arrhythmias of myocardial infarction

Oral tocainide was used as a long-term antiarrhythmic in patients with symptomatic high-grade ventricular ectopic activity refractory to conventional antiarrhythmic agents. Eleven of the 22 patients had a previous myocardial infarction (three patients had a ventricular aneurysm). Unacceptable side effects precluded long-term use of tocainide in two patients. Long-term tocainide was effective in six of the remaining patients for periods of 9 days to 42.5 months (mean 15.2 months). Eight of these nine patients responded to intravenous lidocaine prior to tocainide therapy.