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Encainide in lethal ventricular arrhythmias evaluated by electrophysiologic testing and decrease in symptoms.

L N Horowitz

    The American Journal of Cardiology
    |August 29, 1986
    PubMed
    Summary
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    Encainide hydrochloride shows promise as an antiarrhythmic agent for lethal ventricular arrhythmias like ventricular tachycardia. While it can sometimes worsen arrhythmias, it effectively reduced symptoms and prevented VT initiation in many patients.

    Area of Science:

    • Cardiology
    • Clinical Pharmacology

    Background:

    • Lethal ventricular arrhythmias, including ventricular tachycardia (VT) and ventricular fibrillation, pose significant clinical challenges.
    • Encainide hydrochloride is an antiarrhythmic drug with distinct electrophysiologic properties.

    Purpose of the Study:

    • To evaluate the efficacy and safety of encainide hydrochloride in patients with lethal ventricular arrhythmias.
    • To assess the antiarrhythmic effects of both intravenous and oral encainide administration.

    Main Methods:

    • Electrophysiologic testing was used to evaluate encainide's effect on inducible sustained VT.
    • Patients received intravenous encainide (0.5-1.7 mg/kg) or oral encainide (100-300 mg/day).
    • Concordance of results between intravenous and oral administration was assessed.

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    Main Results:

    • Intravenous encainide prevented VT initiation in 21% of patients with inducible VT.
    • Oral encainide prevented VT initiation in 30% of patients with refractory VT.
    • Encainide administration showed 93% concordance between intravenous and oral routes; however, it could also worsen arrhythmias by converting nonsustained VT to sustained VT.

    Conclusions:

    • Encainide hydrochloride appears to be a useful antiarrhythmic agent for managing lethal ventricular arrhythmias.
    • Despite potential proarrhythmic effects, encainide demonstrated a reduction in arrhythmia-related symptoms and prevented VT initiation in a significant proportion of patients.