[Evaluation of the anti-arrhythmia effect of intravenous flecainide in supraventricular tachyarrhythmias]. / Valoración antiarrítmica de la flecainida endovenosa en las taquiarritmias supraventriculares.

We studied the effects of intravenous flecainide acetate, given as a single dose of 2 mg/kg in no less than 15 minutes, on 31 patients with supraventricular tachyarrhythmias. Fourteen (87%) of the 16 patients with paroxysmal atrial fibrillation converted to sinus node rhythm. All 7 (100%) of the patients with paroxysmal supraventricular tachycardia converted to sinus node rhythm. Five (60%) of the 8 patients with paroxysmal atrial flutter converted to sinus node rhythm. The average time of conversion, after completion of drug administration, was 15 +/- 20 minutes. The QRS was prolonged an average of 82 to 91 milliseconds; in those cases who converted, the PR interval duration was 180 milliseconds average; QT was prolonged an average of 425-450 milliseconds. There were no changes in the JT interval, and we observed no hemodynamic untoward effects.

Estudio clínico multicéntrico comparativo de la flecainida y la amiodarona en el tratamiento de las arritmias ventriculares asociadas a la cardiopatia chagasica cronica / Flecainide and amiodarone in the treatment of ventricular arrhythmias associated with chagas heart disease

En 81 pacientes con miocarditis crónica chagásica (MCC) y arritmias ventriculares (AV) pertenecientes a 4 centros cardiológicos se evaluó comparativamente la eficacia y seguridad de flecainida (F) y amiodarona (A) utilizando un protocolo abierto, randomizado y paralelo. Fueron incluídos pacientes con un número de extrasístoles ventriculares (EV) no inferior a 1200/24 hs y/o formas repetitivas. Los pacientes fueron tratados durante 60 días con una de las drogas (F: 200 a 400 mg/día; A: 800 a 400 mg/día; dosis ajustada según respuesta) y evaluados clínicamente con exámenes de laboratorio, ECG en reposo y ECG ambulatorios continuos de 24 hs (H) días - 7; - 1; 8/9; 15/16; y 59/60). Los porcentajes de reducción de EV obtenidos a los 9, 16 y 60 días con F fueron 73.1%; 82.9% y 92.4% y con A77.6%; 90.1% y 90.7%. Después de 60 días de tratamiento, la Fredujo las duplas en 92.5% y los episodios de taquicardia ventricular en 96.5% y la A, 95.2% y 92.6%, respectivamente. El tratamiento debió ser interrumpido en 6 pacientes; 3 con F (2 por bradicardia sinusal extrema y 1 por TV iterativa), y 3 con A (1 por TV sostenida y 2 por fotodermatosis severa). Aunque existieron algunas diferencias llamativas en los resultados de los distintos centros, El análisis estadísticos en conjunto sugiere una similar eficacia de F y A en el tratamiento de las AV de la MCC

[Comparative multicenter clinical study of flecainide and amiodarone in the treatment of ventricular arrhythmias associated with chronic Chagas cardiopathy]. / Estudio clínico multicéntrico comparativeo de la flecainida y la amiodarona en el tratamiento de las arritmias ventriculares asociadas a la cardiopatía chagásica cronica.

Eighty one patients with ventricular arrhythmias associated with chronic Chagas disease participated in this multi-clinic study. Treatment with Amiodarone and Flecainide were compared using an open, parallel, randomized experimental design. Inclusion criteria required the selected patients to have 1,200 premature ventricular contractions per 24 hours and/or repetitive ventricular arrhythmias. Patients received 60 days of treatment with either Flecainide at 200 to 400 mg per day or Amiodarone 800 to 400 mg per day. This dosage was adjusted to the therapeutic response. Clinical and laboratory evaluations, electrocardiogram and 24 hour Holters were performed at study days: -7, -1, 8/9, 15/16 and 59/60. The percentage reduction of premature ventricular contractions at days 9, 16 and 60 were: 73.1%, 82.9% and 92.4% with Flecainide and 77.6%, 90.1% and 90.7% with Amiodarone. At the end of the study, Flecainide had induced a 92.5% reduction in couplets and 96.5% reduction in ventricular tachycardia. For the same parameters the percentages following Amiodarone were 95.2% and 92.6% respectively. Treatment was discontinued in three patients in the Flecainide group (two because of prolonged sinus node bradycardia and one because of sustained ventricular tachycardia). In the Amiodarone group, treatment was discontinued also in three patients (one because of sustained ventricular tachycardia and two because of severe photosensitive dermatosis). Although there were some differences in the results form center to center, the conclusions from the overall data indicate a similar, therapeutic effect with both drugs.