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[Elevated plasma flecainide concentrations in heart failure].

J Nitsch1, L Neyses, U Köhler

  • 1Medizinische Universitätsklinik, Innere Medizin-Kardiologie, Bonn.

Deutsche Medizinische Wochenschrift (1946)
|October 30, 1987
PubMed
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High flecainide plasma concentrations may occur in heart failure patients. Monitoring or reducing flecainide dosage is recommended for those with reduced left ventricular function.

Area of Science:

  • Cardiology
  • Clinical Pharmacology

Background:

  • Flecainide is a common antiarrhythmic drug.
  • Heart failure can affect drug pharmacokinetics.

Purpose of the Study:

  • To investigate flecainide plasma concentrations in heart failure patients.
  • To correlate flecainide levels with heart failure severity and left ventricular ejection fraction.

Main Methods:

  • Plasma flecainide concentrations were measured in 42 heart failure patients on long-term treatment.
  • Concentrations were compared with clinical heart failure grade and left ventricular ejection fraction (LVEF).

Main Results:

  • Mean plasma flecainide concentration was 415 +/- 244 ng/ml.
  • A negative correlation (r = -0.60) was observed between flecainide levels and LVEF.

Related Experiment Videos

  • Seven patients with high flecainide levels (>700 ng/ml) had severe heart failure (NYHA class III-IV) and low LVEF (24-44%).

    • Conclusions:

    • High, potentially toxic, flecainide plasma concentrations can occur in heart failure patients.
    • Dosage reduction or therapeutic drug monitoring is advised for heart failure patients with reduced left ventricular function on flecainide.