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To the Editor:
Logigian et al.1 conclude that mexiletine is safe and effective for the treatment of myotonia in patients with myotonic dystrophy type 1 (DM1). Unfortunately, the limited duration crossover trial conducted in just 30 patients cannot assure the cardiac safety of this potent sodium channel blocker if extensively used in the DM1 population.
Conduction abnormalities leading to life-threatening arrhythmias are common in DM1.2,3 Mexiletine, like all sodium blockers, not only inhibits the skeletal muscle channel but also …
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