Indications for mexiletine in the new ESC guidelines and beyond.

Expert Opin Pharmacother

Department of Cardiology, J. W. Goethe University, Frankfurt Am Main, Germany.

Published: November 2023

Introduction: Mexiletine is a class IB sodium-channel blocker. Unlike class IA or IC antiarrhythmic drugs, mexiletine rather shortens than prolongs action potential duration; therefore, it is less associated with proarrhythmic effects.

Areas Covered: Recently, new European Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death were published, including a reappraisal of some established older antiarrhythmic drugs.

Expert Opinion: Mexiletine offers a first-line, genotype-specific treatment strategy for LQT3 patients as emphasized by the most recent guidelines. Besides this recommendation, current study reports suggest that in therapy-refractory ventricular tachyarrhythmias and electrical storms adjunctive mexiletine treatment may offer the possibility of stabilizing patients with or without concomitant interventional therapy such as catheter ablation.

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Source
http://dx.doi.org/10.1080/14656566.2023.2223964DOI Listing

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