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Adverse Hemodynamic and Clinical Effects of Encainide in Severe Chronic Heart Failure

Stephen S. Gottlieb, MD; Marrick L. Kukin, MD; Madeline Yushak, BA, RN; Norma Medina, RN; and Milton Packer, MD
[+] Article, Author, and Disclosure Information

Grant Support: Partial support by grant T32 HL 07347 from the National Heart, Lung and Blood Institute. Dr. Packer is the recipient of a Research Career Development award, K01 HL 01229, from the National Institutes of Health.

Requests for Reprints: Stephen S. Gottlieb, MD, Division of Cardiology, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201.

Current Author Addresses: Dr. Gottlieb: University of Maryland Hospital, 22 South Greene Street, Baltimore, MD 21201.

Drs. Kukin and Packer and Ms. Yushak and Ms. Medina: Mt. Sinai School of Medicine, 100th Street and Madison Avenue, New York, NY 10029.

©1989 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1989;110(7):505-509. doi:10.7326/0003-4819-110-7-505
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Study Objective: To evaluate the hemodynamic effects of the antiarrhythmic drug, encainide, in patients with severe chronic heart failure.

Design: Unblinded, before-after study.

Setting: Referral center for patients with heart failure.

Patients: Thirty patients with severe chronic heart failure and a left ventricular ejection fraction less than 40%.

Interventions: Invasive hemodynamic measurements were done (using a balloon-tipped thermodilution catheter) before and for 3 hours after a single oral dose of 50 mg of encainide.

Measurements and Main Results: Ninety to one hundred and twenty minutes after its administration, encainide produced a significant deterioration in cardiac performance, as reflected by a fall in cardiac index from 2.3 to 1.8 L/min·m2 body surface





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