Mexiletine: Antiarrhythmic mechanisms, emerging clinical applications and mortality

Farah Olleik; Mohammed Hussein Kamareddine; Jenna Spears; Gary Tse; Tong Liu; Gan Xin Yan

doi:10.1111/pace.14846

Mexiletine: Antiarrhythmic mechanisms, emerging clinical applications and mortality

Farah Olleik, Mohammed Hussein Kamareddine, Jenna Spears, Gary Tse, Tong Liu, Gan Xin Yan

Research output: Contribution to journal › Review article › peer-review

5 Citations (Scopus)

Abstract

Mexiletine, a class Ib antiarrhythmic drug, exhibits its major antiarrhythmic effect via inhibition of the fast and late Na⁺ currents in myocardial tissues that are dependent on the opening of Na⁺ channels for their excitation. Through a comprehensive examination of mexiletine's therapeutic benefits and potential risks, we aim to provide valuable insights that reinforce its role as a vital therapeutic option for patients with ventricular arrhythmias, long QT syndrome, and other heart rhythm disorders. This review will highlight the current understandings of the antiarrhythmic effects and rationales for recent off-label use and address the mortality and proarrhythmic effects of mexiletine utilizing published basic and clinical studies over the past five decades.

Original language	English
Pages (from-to)	1348-1356
Number of pages	9
Journal	PACE - Pacing and Clinical Electrophysiology
Volume	46
Issue number	11
DOIs	https://doi.org/10.1111/pace.14846
Publication status	Published - Nov 2023

Keywords

antiarrhythmic effects
atrial fibrillation
drug safety
long QT syndrome
mexiletine
mortality
pharmacokinetics
proarrhythmias
ventricular tachycardia

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10.1111/pace.14846

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title = "Mexiletine: Antiarrhythmic mechanisms, emerging clinical applications and mortality",

abstract = "Mexiletine, a class Ib antiarrhythmic drug, exhibits its major antiarrhythmic effect via inhibition of the fast and late Na+ currents in myocardial tissues that are dependent on the opening of Na+ channels for their excitation. Through a comprehensive examination of mexiletine's therapeutic benefits and potential risks, we aim to provide valuable insights that reinforce its role as a vital therapeutic option for patients with ventricular arrhythmias, long QT syndrome, and other heart rhythm disorders. This review will highlight the current understandings of the antiarrhythmic effects and rationales for recent off-label use and address the mortality and proarrhythmic effects of mexiletine utilizing published basic and clinical studies over the past five decades.",

keywords = "antiarrhythmic effects, atrial fibrillation, drug safety, long QT syndrome, mexiletine, mortality, pharmacokinetics, proarrhythmias, ventricular tachycardia",

author = "Farah Olleik and Kamareddine, \{Mohammed Hussein\} and Jenna Spears and Gary Tse and Tong Liu and Yan, \{Gan Xin\}",

note = "Publisher Copyright: {\textcopyright} 2023 Wiley Periodicals LLC.",

year = "2023",

month = nov,

doi = "10.1111/pace.14846",

language = "English",

volume = "46",

pages = "1348--1356",

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TY - JOUR

T1 - Mexiletine

T2 - Antiarrhythmic mechanisms, emerging clinical applications and mortality

AU - Olleik, Farah

AU - Kamareddine, Mohammed Hussein

AU - Spears, Jenna

AU - Tse, Gary

AU - Liu, Tong

AU - Yan, Gan Xin

PY - 2023/11

Y1 - 2023/11

N2 - Mexiletine, a class Ib antiarrhythmic drug, exhibits its major antiarrhythmic effect via inhibition of the fast and late Na+ currents in myocardial tissues that are dependent on the opening of Na+ channels for their excitation. Through a comprehensive examination of mexiletine's therapeutic benefits and potential risks, we aim to provide valuable insights that reinforce its role as a vital therapeutic option for patients with ventricular arrhythmias, long QT syndrome, and other heart rhythm disorders. This review will highlight the current understandings of the antiarrhythmic effects and rationales for recent off-label use and address the mortality and proarrhythmic effects of mexiletine utilizing published basic and clinical studies over the past five decades.

AB - Mexiletine, a class Ib antiarrhythmic drug, exhibits its major antiarrhythmic effect via inhibition of the fast and late Na+ currents in myocardial tissues that are dependent on the opening of Na+ channels for their excitation. Through a comprehensive examination of mexiletine's therapeutic benefits and potential risks, we aim to provide valuable insights that reinforce its role as a vital therapeutic option for patients with ventricular arrhythmias, long QT syndrome, and other heart rhythm disorders. This review will highlight the current understandings of the antiarrhythmic effects and rationales for recent off-label use and address the mortality and proarrhythmic effects of mexiletine utilizing published basic and clinical studies over the past five decades.

KW - antiarrhythmic effects

KW - atrial fibrillation

KW - drug safety

KW - long QT syndrome

KW - mexiletine

KW - mortality

KW - pharmacokinetics

KW - proarrhythmias

KW - ventricular tachycardia

UR - https://www.scopus.com/pages/publications/85174260191

U2 - 10.1111/pace.14846

DO - 10.1111/pace.14846

M3 - Review article

C2 - 37846818

AN - SCOPUS:85174260191

SN - 0147-8389

VL - 46

SP - 1348

EP - 1356

JO - PACE - Pacing and Clinical Electrophysiology

JF - PACE - Pacing and Clinical Electrophysiology

IS - 11

ER -

Mexiletine: Antiarrhythmic mechanisms, emerging clinical applications and mortality

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