The effects of aprindine hydrochloride, an antiarrhythmic drug of the class IB, on heart rate variability were evaluated in 13 patients (eight men and five women), ages 76 ± 11 years, who showed a standard deviation of the R-R interval measured at 5-minute intervals (SDANN) of ⩽100 msec on 24-hour electrocardiograms. After 24-hour electrocardiograms were recorded during the control period, aprindine was administered at a dose of 60 mg/day. After 2 weeks of treatment 24-hour electrocardiograms were again recorded. The SDANN was ⩽100 msec (mean, 69.3 ± 17.0 msec) in all patients during the control period, but increased after aprindine administration (mean, 86.1 ± 31.5 msec, P