Effects of flecainide on ventricular function: clinical and experimental correlations

Area of Science:

• Cardiology
• Clinical Pharmacology

Background:

• Flecainide is a potent antiarrhythmic drug with known electrophysiologic properties.
• Its inotropic and hemodynamic effects, particularly in patients with cardiac conditions, are not well-established.

Purpose of the Study:

• To evaluate the inotropic and hemodynamic actions of flecainide acetate.
• To assess the drug's effects in patients with ischemic heart disease.

Main Methods:

• Isolated rabbit papillary muscle studies to determine inotropic effects.
• Intravenous administration of flecainide acetate (1 and 2 mg/kg) to patients undergoing coronary angiography.
• Hemodynamic parameters including heart rate, arterial pressure, and cardiac output were monitored.

Main Results:

• Flecainide acetate demonstrated a concentration-dependent negative inotropic effect in isolated muscle.
• In patients, flecainide acetate did not alter heart rate or mean arterial pressure.
• Significant increases in right atrial pressure, wedge pressure, pulmonary artery pressure, and pulmonary vascular resistance were observed.
• Cardiac index, stroke volume index, stroke work index, and left ventricular ejection fraction significantly decreased.

Conclusions:

• Flecainide acetate possesses negative inotropic properties.
• The drug induces significant adverse hemodynamic changes and reduces left ventricular function in patients with ischemic heart disease.