Antiarrhythmic effects of flecainide

Abstract

A new class I antiarrhythmic, flecainide [FC], was investigated in 10 patients to assess short-term efficacy and safety. All patients were hospitalized for 3 days; no antiarrhythmics were given on days 1 and 3. On day 2 FC 1 mg/kg was given i.v. over 5 min. If the predrug arrhythmia(s) was not completely suppressed, additional boluses of 0.5 mg/kg were injected at 30-60 min intervals to a maximum of 2 mg/kg. Seven patients received 2 mg/kg, and 3 patients received 1 mg/kg. Before the drug, 5 patients had premature ventricular contractions (PVC) (more than 4 per min); 2 patients had atrial fibrillation (AF) with PVC; 1 patient had both PVC and premature atrial contractions (PAC); and 2 patients had only PAC. One patient with PVC failed to respond to FC; he was unresponsive to all available antiarrhythmic drugs. In the other 7 patients PVC were suppressed for an average of 13 h (range 6-24 h), AF was not affected, and PAC were suppressed. FC did not induce significant changes in P-R, QRS or Q-T intervals. Side effects were negligible and included a tingling sensation and feeling of skin warmth for 15 min after drug in 1 patient.