Use of flecainide acetate in the treatment of premature ventricular contractions

Flecainide acetate, a new benzamide antiarrhythmic agent, was studied after single-dose intravenous administration to 35 male and female patients with nonlife-threatening premature ventricular contractions (PVCs). Prior Holter monitoring established that each patient had "stable" PVCs of at least 600/12 hr. PCV in 80% of the patients was attributed to underlying coronary heart disease and/or Chagas' disease. After bolus injections of flecainide acetate, cardiac rhythm was again monitored by Holter ECG recording for 24 hours. All patients had 100% suppression of PVCs, ranging from 60 to 1440 minutes in duration. The average duration of suppression for all patients was more than 8 hours (498 minutes). Follow-up at 6, 12, 18, and 24 hours showed statistically significant PVC reductions (p less than 0.01) when compared with control rates. Side effects were trivial. The extended half-life of this new agent (about 20 hours in cardiac patients) may allow a convenient twice-daily dosage schedule.