An Experience of Meldonium Use in Patients with Ventricular Arrhythmias of Ischemic Genesis

Ischemic heart disease (IHD) is often accompanied by cardiac rhythm disturbances particularly ventricular arrhythmias (VA) and their appearance in both chronic and acute forms of IHD is usually regarded as dangerous signal requiring the use of antiarrhythmic drugs. An important addition to hemodynamic therapy can be considered the use of cytoprotective drugs that improve the energy potential of cardiomyocytes. The purpose of this work is to study the comparative evaluation of the Mildronate effectiveness in patients with IHD and VA.

Methods. Under dynamic observation were 147 patients with IHD and VA (Lown II–IV functional class). The diagnosis of angina pectoris was confirmed by clinical, exercise bicycle ergometry, Holter ECG monitoring, and echocardiography data. Holter ECG monitoring was used for recording VA, heart rate, episodes of ST-segment depression. The levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol were determined. All patients were randomly divided into 2 groups. The first group (81 patients) received standard antianginal and antiarrhythmic therapy plus meldonium for 2 months. The second (control) group (66 patients) received standard antianginal and antiarrhythmic therapy only. Statistical analysis of the data was carried out using the statistical package SPSS 13.0.

Results. A comparative analysis of the results showed that the use of meldonium in combination with basic therapy significantly improved clinical condition and quality of life indicators, increased exercise tolerance and improved systolic and diastolic dysfunction in patients with IHD and VA. The positive effect of meldonium on LDLC levels was observed. Moreover, the combination of basic antianginal and antiarrhythmic therapy and meldonium in patients with ischemic genesis VA promoted significant reduction of ischemic episodes and decrease of VA, in particular allorhythmia.

Conclusion. Results of this study suggest that the use of meldonium in patients with IHD and VA helps to optimize myocardial energy metabolism in conditions of ischemia and reperfusion.

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