Flecainide acetate in the treatment of resistant supraventricular arrhythmias

Thirty-one patients with a variety of supraventricular tachyarrhythmias resistant to conventional anti-arrhythmic therapy were treated with flecainide acetate, a new class Ic antiarrhythmic drug. The mean follow-up period was 7 months. Control was attained in 19 patients (62%) initially, and the long-term success rate was 39%. In 7 of the 19 controlled patients the drug was subsequently discontinued because of major side-effects, which included negative inotropism and pro-arrhythmia. The mechanisms and implications of these side-effects are reviewed.