Effectiveness of mexiletine in senile hypertensives with repetitive ventricular arrhythmias and serum mexiletine concentration measured with HPLC.

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This study was designed to investigate the effectiveness, hemodynamic effects, and serummexiletine concentration in senile hypertensives with repetitive ventricular arrhythmias.Mexiletine, 100mg t. i. d. was administered in 10 senile hypertensives. Blood pressure, echocardiogram, 24-hr ambulatory ECG were obtained before and after medication. Serummexiletine concentration was measured by HPLC (High Performance Liquid Chromatography). Cardiac output, mean velocity of circumferential fiber shortening were calculatedfrom LVDd, LVDs, HR, ejection time by echocardiogram. The effcacy of mexiletine wasassessed by 24-hr ECG with comnuter analysis.<BR>No repetitive ventricular arrhythmias were found in all patients by administration ofmexiletine. Number of ventricular arrhythmias decreased from 925 to 120 per day. Althoughthey have low cardiac performance, no significant change was found in hemodynamics. Theaverage of serum mexiletine concentration was 0.75 μg/ml (equal to that of adult). Seriousuntoward effects were not found in all patients.<BR>In conclusion, orally administered mexiletine was very effective in the treatment ofrepetitive ventricular arrhythmias in senile hypertensives with conventional doses similarto that in middle-aged subjects and also, HPLC was thought to be superior to gas chromatography because of its rapidity, accuracy, and lower cost.
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