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To the Editor—Mexiletine in myotonic dystrophy: Beware of ventricular arrhythmias!

Published:December 17, 2020DOI:https://doi.org/10.1016/j.hrthm.2020.11.031
      Vio et al
      • Vio R.
      • Zorzi A.
      • Bello L.
      • et al.
      Evaluation of mexiletine effect on conduction delay and bradyarrhythmic complications in patients with myotonic dystrophy type 1 over long-term follow-up.
      have reported data on the safety of mexiletine in patients with myotonic dystrophy type 1 (MD). They included cases without major conduction disturbances who did not develop serious bradyarrhythmic events after 9-year follow-up. These results are reassuring for daily practice, but mexiletine benefits in patients with MD and HV interval > 70 ms and an implanted pacemaker must be carefully counterbalanced with the potential risk of ventricular arrhythmias.
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