Clinical efficacy and safety of pirmcnol in patients of arrhythmia with organic heart diseases

Clinical usefulness and safety of pirmenol were evaluated in 20 patients, including 15 arrhythmias of premature ventricular contractions (PVCs), 6 of paroxysmal atrial fibrillation (PAF) and 2 of paroxysmal supraventricular tachycardia (PSVT). Three patients had combined arrhythmias. Basic heart diseases of the patients were hypertensive heart disease in 10, old myocardial infarction in 4, angina pectoris in 3, cardiomyopathy in 4, valvular heart disease in 2, sick sinus syndrome in 1 and WPW syndrome in 1. Three patients had 2 diseases, respectively and one patient combined 3 diseases. Firstly, patients received pirmenol at a daily dose of 100 mg (b.i.d) for the period from 3 days to 2 weeks before continuous administration of pirmenol, to confirm the efficacy and safety of pirmenol. When pirmenol improved the arrhythmia, 100 mg daily dose was continued for further 4 weeks. If the dose of pirmenol had enough improving effect on the arrhythmia, dose was increased up to 150 mg (t.i.d) as the second step. In the 2nd step, the continuous administration of 150mg pirmenol also followed the preliminary administration of the same dosage for the period from 3 days to 1 week. The rates of "improved" or better in the improvement rating of PVCs and PAF/PSVT were 86. 7% and 100%, respectively. The rates of "improved" or better in subjective symptoms and global improvement rating were also high in both arrhythmias. Significant abnormal ECG changes were not observed in any patients. Pirmenol induced neither cardiodepressive effects nor significant hemodynamic changes in those patients. Adverse effect, diarrhea, occurred in 1 patient but recovered after cessation of the drug without any treatment. In the patients with mild to moderate organic heart diseases, pirmenol improved both ventricular and supraventricular arrhythmias without serious side effects by the stepwise administration from small dosage. Long term effectiveness and safety of pirmenol in the patients with heart disease should wait another study.