The tolerance and efficacy of
propafenone were studied in cases of chronic
ventricular extrasystoles of the elderly (age greater than 70 years). Only patients presenting more than 1,000
extrasystoles per day and requiring a treatment, were included in this study. Patients presenting non-compensated cardiac insufficiency, hypotensive patients, patients with conduction disorders without pacemakers as well as patients presenting a severe renal or
hepatic insufficiency, were excluded. After making sure that the rhythm disorder was chronic, a control Holter was performed, then, 600 mg of
propafenone per day, in 3 doses were prescribed for 5 days. On the 5th day, a Holter was performed as well as a blood
propafenone level. Some patients received then 900 mg per day with a new Holter and plasma
propafenone titration on the 10th day. 11 patients were studied in this fashion. The tolerance to 600 mg was good in 10 out of 11 cases. The efficacy, appreciated by the decrease of the number of isolated
ventricular extrasystoles (-69%), doublets (-95%), triplets (-98%) and salvos of
ventricular tachycardias (-100%), was excellent in 6 cases, average in 2 cases and mediocre in 3 cases. Increase of the dosage to 900 mg does not improve significantly the
anti-arrhythmic efficacy while the side effects seem more frequent. It is not possible to establish a relationship between plasma concentrations and efficacy. At a dosage of 600 mg per day,
propafenone is therefore effective in the treatment of
ventricular extrasystoles in elderly patients and its tolerance is good. Higher doses are not advisable as they seem much less well tolerated without any additional advantage.