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Long-term antiarrhythmic therapy with flecainide.

T Meinertz, M K Zehender, A Geibel

    The American Journal of Cardiology
    |July 1, 1984
    PubMed
    Summary
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    Oral flecainide effectively treated serious ventricular arrhythmias in a long-term study. This antiarrhythmic drug demonstrated high efficacy and good tolerability in patients with complex ventricular arrhythmias.

    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Ventricular arrhythmias pose a significant clinical challenge.
    • Existing antiarrhythmic agents may have limitations in efficacy or tolerability.

    Purpose of the Study:

    • To evaluate the long-term antiarrhythmic efficacy and safety of oral flecainide.
    • To assess flecainide's effectiveness in patients with frequent and complex ventricular arrhythmias resistant to other treatments.

    Main Methods:

    • A 2-week controlled trial followed by a 48-week long-term study.
    • Fifteen patients with Lown grade IVA or IVB ventricular arrhythmias were enrolled.
    • Efficacy was monitored using 24-hour Holter monitoring at specified intervals.
    • Dosage was titrated to achieve optimal therapeutic effect.

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    Main Results:

    • Flecainide achieved over 90% suppression of ventricular premature contractions (VPCs) and complex ventricular arrhythmias in 14 of 15 patients.
    • The minimum effective dose ranged from 100 to 200 mg twice daily.
    • No significant changes were observed in PQ, QRS duration, QTc, or JTc intervals.
    • Side effects were mild, tolerable, and decreased over time, with only 2 of 14 patients experiencing them at 48 weeks.

    Conclusions:

    • Oral flecainide is a highly effective antiarrhythmic agent for long-term management of serious ventricular arrhythmias.
    • The drug is well-tolerated, with a low incidence of mild and manageable side effects during extended use.