Safety and Efficacy of Oral Flecainide Acetate in Patients with Cardiac Arrhythmias.

概要

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We retrospectively studied the clinical efficacy and safety of oral flecainide in 38 patients with symptomatic arrhythmias. Patients received 100 to 200mg daily of flecainide for a mean of 25 months (range 8 to 50 months). All patients had normal cardiac function. Paroxysmal atrial fibrillation (PAF) was observed in 29 patients (76%). Other forms of arrhythmia included paroxysmal atrial flutter, seen in 3 patients (8%); premature atrial contraction and ventricular premature contraction, each seen in 2 patients (5%); and supraventricular tachycardia and ventricular tachycardia, each seen in 1 patient (3%). A complete response was obtained in 15 (52%) of 29 patients with PAF and a partial response in 8 patients (27%). The remaining 6 patients (21%) showed no response. A complete response was also obtained in 7 of 9 patients with other forms of arrhythmia. There were no differences in cardiac function and ECG parameters before and after treatment. Flecainide was withdrawn in 4 patients due to the development of electrocardiographic abnormalities. Three of these patients showed an atrial proarrhythmic effect. Abnormal ST elevations in the precordial leads were observed in 1 patient who received 200mg of flecainide daily. In conclusion, flecainide was effective treatment for supraventricular and ventricular arrhythmias, but attention must be paid to the drug's potential proarrhythmic adverse effects.