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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Haemodynamic and antiarrhythmic effects of intravenous flecainide acetate in chronic congestive heart failure

P H Dunselman, J H Kingma, L M van Wijk

    Drugs
    |January 1, 1985
    PubMed

    Insights

    Flecainide acetate effectively suppressed ventricular arrhythmias in heart failure patients. Doubling infusion time ensured safety and good antiarrhythmic efficacy, even at lower plasma concentrations.

    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Congestive heart failure (CHF) patients often experience ventricular arrhythmias.
    • Class Ic antiarrhythmic agents, like flecainide acetate, require careful evaluation in heart failure populations due to potential proarrhythmic effects.

    Purpose of the Study:

    • To assess the hemodynamic and antiarrhythmic effects of flecainide acetate in patients with heart failure.
    • To determine the safety and efficacy of flecainide acetate administration in this patient group.

    Main Methods:

    • Intravenous administration of flecainide acetate (2 mg/kg) over 60 minutes to 9 patients with CHF and ventricular arrhythmias.
    • Monitoring of hemodynamic parameters (cardiac index, pulmonary wedge pressure, pre-ejection period, ejection time) and arrhythmia suppression.

    Main Results:

    • Significant reduction (90%) in ventricular arrhythmias in 6 out of 9 patients for an average of 6.5 hours.
    • Hemodynamic changes included increased pre-ejection period and pulmonary wedge pressure, and decreased cardiac index.
    • Parameters normalized upon infusion completion; no significant changes in stroke work index, arterial pressure, or vascular resistance.

    Conclusions:

    • Flecainide acetate (2 mg/kg) can be safely administered to CHF patients when the infusion time is doubled.
    • Good antiarrhythmic efficacy is achievable with this modified administration protocol, even at lower plasma concentrations.

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