Amiodarone/mexiletine: Lack of efficacy: case report.

A 52-year-old man with a history of smoking, ischemic heart disease, and heavy alcohol consumption experienced lack of efficacy during treatment with amiodarone and mexiletine for sustained monomorphic ventricular tachycardia (SMVT). Despite receiving therapy, he continued to experience frequent refractory SMVT. Amiodarone therapy was discontinued and the episodes were effectively treated with an implantable cardioverter defibrillator (ICD) shock. The patient underwent stereotactic arrhythmia radioablation (STAR) and was discharged in good clinical condition with medication included mexiletine. At 3 months of follow-up, he reported a new single episode of VT which was treated with ICD shock. [Extracted from the article]