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  1. Home
  3. Efficacy Of Flecainide In Pacing-induced Sustained Ventricular Tachyarrhythmias: Correlation To Clinical Parameters And Tachycardia-characteristics.
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Efficacy Of Flecainide In Pacing-induced Sustained Ventricular Tachyarrhythmias: Correlation To Clinical Parameters And Tachycardia-characteristics.

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Efficacy of flecainide in pacing-induced sustained ventricular tachyarrhythmias: correlation to clinical parameters

A Podczeck1, M Borggrefe, K Bartels

  • 1Hospital of the Westfälische Wilhelms-University of Münster, Department of Internal Medicine C (Cardiology and Angiology), West Germany.

European Heart Journal
|October 1, 1989

View abstract on PubMed

Summary
This summary is machine-generated.

Flecainide effectively reduced inducible ventricular tachycardia (VT) in 32% of patients. This antiarrhythmic drug also slowed VT rates and increased ventricular refractoriness, improving outcomes for VT patients.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Sustained ventricular tachycardia (VT) and syncope of unknown origin pose significant clinical challenges.
  • Electrophysiologic evaluation is crucial for diagnosing and managing these conditions.

Purpose of the Study:

  • To evaluate the efficacy of flecainide in patients with inducible sustained ventricular tachycardia (VT) or syncope of unknown origin.
  • To assess flecainide's impact on VT inducibility, rate, and ventricular electrophysiologic properties.

Main Methods:

  • Seventy-two patients underwent electrophysiologic studies before and after flecainide therapy (200-300 mg/day).
  • VT inducibility, VT rate, and right ventricular effective refractory period (ERP) were measured.
  • Factors influencing flecainide response, including left ventricular aneurysm and baseline VT characteristics, were analyzed.

Main Results:

  • Flecainide rendered VT non-inducible in 25% of patients and made it more difficult to induce in an additional 7%, showing overall efficacy in 32%.
  • VT rate decreased significantly (214 to 178 beats/min, P<0.01) and right ventricular ERP increased (251 to 267 ms, P<0.01).
  • Lack of response correlated with left ventricular aneurysm; higher baseline VT rates (>230 beats/min) and induced ventricular fibrillation (VF) predicted better response.

Conclusions:

  • Flecainide is an effective antiarrhythmic agent for a subset of patients with inducible VT, reducing inducibility and slowing VT rates.
  • Baseline electrophysiologic characteristics, particularly VT rate and inducibility of VF, can predict response to flecainide.
  • While generally well-tolerated, flecainide efficacy is limited in patients with left ventricular aneurysms, and side effects may necessitate discontinuation.