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Related Experiment Videos

Influence of left ventricular dysfunction on flecainide therapy.

A A de Paola, L N Horowitz, J Morganroth

    Journal of the American College of Cardiology
    |January 1, 1987
    PubMed
    Summary

    Flecainide effectively treats ventricular tachyarrhythmias, but heart failure risk increases with reduced ejection fraction. Patients with ejection fraction below 30% experienced lower flecainide efficacy and tolerance.

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    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Ventricular tachyarrhythmias require effective antiarrhythmic drug therapy.
    • Flecainide is an oral antiarrhythmic medication used for these conditions.
    • Left ventricular ejection fraction (LVEF) is a key indicator of cardiac function.

    Purpose of the Study:

    • To evaluate the efficacy and safety of oral flecainide in patients with ventricular tachyarrhythmias.
    • To determine the impact of left ventricular ejection fraction on flecainide's effectiveness and tolerability.

    Main Methods:

    • Seventy-six patients with ventricular tachyarrhythmias received oral flecainide.
    • Patients were stratified based on LVEF (<=30% vs. >30%) and history of heart failure.
    • Efficacy and adverse events, including congestive heart failure, were monitored.

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    Main Results:

    • Flecainide efficacy and tolerance were significantly higher in patients with LVEF >30% (58%) compared to those with LVEF <=30% (12%).
    • Congestive heart failure occurred in 7 patients, all with LVEF <=30%, particularly those with prior heart failure.
    • LVEF was the sole independent predictor of flecainide efficacy and tolerance.

    Conclusions:

    • Flecainide therapy for ventricular tachyarrhythmias is limited by reduced efficacy and tolerance in patients with LVEF <=30%.
    • Congestive heart failure is a significant risk during flecainide treatment, especially in patients with pre-existing heart failure and low LVEF.