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Efficacy and Risks of Moricizine in Inducible Sustained Ventricular Tachycardia

Roger Damle, MD; Joseph Levine, MD; Jeffrey Matos, MD; Steven Greenberg, MD; Rodney Brooks, MD; William Frumkin, MD; Jeffrey Goldberger, MD; and Alan H. Kadish, MD
[+] Article, Author, and Disclosure Information

Requests for Reprints: Alan H. Kadish, MD, Northwestern Memorial Hospital, 250 East Superior Street, Wesley Pavilion, Suite 524, Chicago, IL 60611.

Current Author Addresses: Drs. Damle, Brooks, Goldberger, and Kadish: Northwestern Memorial Hospital, 250 East Superior Street, Wesley Pavilion, Suite 524, Chicago, IL 60611.

Drs. Levine and Greenberg: St. Francis Hospital, 100 Fort Washington Boulevard, Roslyn, NY 11576.

Drs. Matos and Frumkin: 920 Park Avenue, New York, NY 10028.

© 1992 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1992;116(5):375-381. doi:10.7326/0003-4819-116-5-375
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Objective: To assess the efficacy and toxicity of moricizine in treating patients with serious ventricular arrhythmias and inducible sustained ventricular tachycardia. ▪ Design: Uncontrolled clinical trial.

Setting: The intensive care and telemetry units of Northwestern Memorial Hospital, St. Francis Hospital and Medical Center, and Lenox Hill Hospital.

Patients: Twenty-six patients with sustained ventricular arrhythmias or hemodynamically significant non-sustained ventricular tachycardia, most of whom failed therapy with at least one class I antiarrhythmic agent.

Intervention: Patients were treated with moricizine, 400 to 1000 mg/d.

Measurement: Efficacy was assessed by the results of programmed ventricular stimulation done during moricizine therapy.

Main Results: Seven of the 26 patients (27%) developed life-threatening ventricular proarrhythmia during moricizine loading. Three patients had incessant sustained ventricular tachycardia, two had incessant non-sustained ventricular tachycardia, one had new sustained ventricular tachycardia, and one had new cardiac arrest. One of these patients died of intractable ventricular fibrillation. No clinical or electrophysiologic variables clearly identified those at risk for proarrhythmia. Only 3 of 26 patients (12%) became noninducible on moricizine.

Conclusion: Moricizine has a low rate of efficacy and carries a considerable risk for life-threatening proarrhythmia in patients with serious ventricular arrhythmias and inducible ventricular tachycardia who have failed therapy with other class I antiarrhythmic agents.





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