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Class IC antiarrhythmic drugs for suspected premature ventricular contraction-induced cardiomyopathy

Matthew C Hyman1, Danielle Mustin1, Gregory Supple1

  • 1Section of Cardiac Electrophysiology, Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Heart Rhythm
|February 7, 2018
PubMed

Insights

Class IC antiarrhythmic drugs (IC-AADs) effectively reduced premature ventricular contractions (PVCs) and improved heart function in patients with PVC-induced cardiomyopathy. This study found IC-AADs to be safe and effective in this patient group.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Class IC antiarrhythmic drugs (IC-AADs) effectively suppress premature ventricular contractions (PVCs).
  • However, IC-AADs are associated with increased mortality in post-myocardial infarction patients with PVCs and left ventricular dysfunction.
  • The safety of IC-AADs for treating premature ventricular contraction-induced cardiomyopathy (PVC-CM) is not established.

Purpose of the Study:

  • To determine the safety and efficacy of IC-AADs in patients suspected of having PVC-CM.

Main Methods:

  • Retrospective review of electronic medical records at the Hospital of the University of Pennsylvania.
  • Identification of patients suspected of PVC-CM treated with flecainide or propafenone.
  • Review of clinical, electrocardiographic, and imaging data.

Main Results:

  • Twenty patients with suspected PVC-CM received IC-AADs, with a mean PVC burden reduction from 36.2% to 10.0% (P <.001).
  • Mean left ventricular ejection fraction (LVEF) improved significantly from 37.4% to 49.0% (P <.001).
  • No sustained ventricular arrhythmias or sudden cardiac deaths occurred during an average follow-up of 3.8 years.

Conclusions:

  • IC-AADs effectively suppressed PVCs and improved LVEF in the majority of patients with suspected PVC-CM.
  • No adverse events were observed in this small cohort, suggesting potential safety and efficacy.
Abstract

Keywords:
CardiomyopathyClass IC antiarrhythmic drugFlecainidePremature ventricular contractionPremature ventricular contraction–induced cardiomyopathyPropafenone

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