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To the Editor.—
The implications of the abstract and title of "Bretylium Tosylate: Adverse Effects in Acute Myocardial Infarction" in the Archives (135:515-518, 1975), by Luomanmaki and associates, should not be allowed to stand without comment. Actually, the authors provided no evidence of any adverse effects of the drug in question; rather, they reported favorable effects. They found average peak levels of serum glutamic oxaloacetic transaminase and lactic dehydrogenase to be considerably lower in patients treated with bretylium than in patients treated with lidocaine, although their series was too small to give reliable statistical significance to the favorable effect of bretylium. They themselves say that their "data suggest that bretylium has therapeutic value in the prevention of major ventricular arrhythmias in acute myocardial infarction." No patient in their series on bretylium died while receiving treatment. One died 48 hours after the discontinuation of bretylium administration. Perhaps the most serious defect in
Visscher MB. Bretylium in Acute Myocardial Infarction. Arch Intern Med. 1976;136(4):494. doi:10.1001/archinte.1976.03630040096021
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