Related Experiment Video

Updated: Oct 23, 2026

Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine
10:05

Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine

Published on: July 7, 2016

Comparative haemodynamic effects of intravenous flecainide in patients with and without heart failure and with and

V Legrand, P Materne, M Vandormael

    European Heart Journal
    |August 1, 1985
    PubMed

    Insights

    Flecainide shows negative inotropic effects, particularly in patients with left ventricular dysfunction. These effects on cardiac function are more pronounced in those with heart failure, impacting stroke volume and ejection fraction.

    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Flecainide is an antiarrhythmic drug.
    • Its impact on cardiac function, especially in patients with coronary disease and varying degrees of heart failure, requires detailed investigation.

    Purpose of the Study:

    • To compare the hemodynamic effects of flecainide in patients with coronary disease, stratified by heart failure status.
    • To assess the influence of flecainide on myocardial contractility and systemic hemodynamics.

    Main Methods:

    • Hemodynamic parameters were measured in three groups of patients with coronary disease: no heart failure (A), on beta-blockers (B), and with overt heart failure (C).
    • Measurements included pulmonary wedge pressure, left ventricular stroke volume, stroke work, ejection fraction, end-systolic volume, and dP/dt.

    Main Results:

    • Flecainide induced negative inotropic effects, more pronounced in patients with left ventricular dysfunction.
    • Pulmonary wedge pressure increased, while stroke volume, stroke work, and ejection fraction decreased, with greater magnitude in groups B and C.
    • Myocardial depression, indicated by a fall in dP/dt, was observed, persisting post-infusion.

    Conclusions:

    • Flecainide exerts significant negative inotropic effects, particularly in patients with compromised left ventricular function.
    • The drug's impact is more severe in patients with overt heart failure, suggesting caution in this population.
    • These findings highlight the importance of considering flecainide's myocardial depressant effects in patients with established left ventricular dysfunction.

    More Related Videos

    Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing12:45

    Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

    Published on: December 11, 2017

    Impact of Intracardiac Neurons on Cardiac Electrophysiology and Arrhythmogenesis in an Ex Vivo Langendorff System06:40

    Impact of Intracardiac Neurons on Cardiac Electrophysiology and Arrhythmogenesis in an Ex Vivo Langendorff System

    Published on: May 22, 2018

    Related Concept Videos

    Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

    Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

    Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
    Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
    Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

    Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

    Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which indirectly block calcium...
    Heart Failure Drugs: Inotropic Agents01:26

    Heart Failure Drugs: Inotropic Agents

    Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
    Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

    Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

    The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
    Heart Failure Drugs: β-Blockers01:22

    Heart Failure Drugs: β-Blockers

    β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
    Heart Failure V: Medical Management01:30

    Heart Failure V: Medical Management

    Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...