0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Inefficacy and Proarrhythmic Effects of Flecainide and Encainide for Sustained Ventricular Tachycardia and Ventricular Fibrillation

John M. Herre, MD; Christina Titus, RN; Michael Oeff, MD; Michael Eldar, MD; Michael R. Franz, MD; Jerry C. Griffin, MD; and Melvin M. Scheinman, MD
[+] Article and Author Information

Requests for Reprints: John M. Herre, MD, Electrophysiology Laboratory, Sentara Norfolk General Hospital, 600 Gresham Drive, Norfolk, VA 23507.

Current Author Addresses: Dr. Herre: Electrophysiology Laboratory, Sentara Norfolk General Hospital, 600 Gresham Drive, Norfolk, VA 23507.

Ms. Titus: Pacific Coast Clinical Coordinators, Inc., 643 Bair Island Rd., Suite 106, Redwood City, CA 94062.

Dr. Oeff: Klinikum Steglitz, Hindenburg Damm 30, 1 Berlin 45, Federal Republic of Germany.

Dr. Eldar: Neufeld Cardiac Research Institute, Sheba Medical Center, Tel Hashomer 52621, Israel.

Dr. Franz: Cardiology Division, Stanford University Medical Center, Stanford, CA 94305.

Drs. Griffin and Scheinman: Room 312, Moffitt Hospital, University of California, San Francisco, CA 94143-0214.


© 1990 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1990;113(9):671-676. doi:10.7326/0003-4819-113-9-671
Text Size: A A A

Objective: To assess the efficacy of encainide and flecainide in treating patients with sustained ventricular arrhythmias.

Design: Patients were treated with encainide or flecainide. Efficacy was assessed by comparing the results of programmed ventricular stimulation while patients received therapy with the results while they were drug free.

Setting: The electrophysiology laboratory of the University of California at San Francisco.

Patients: Forty-nine patients with spontaneous or inducible sustained ventricular tachycardia or ventricular fibrillation for whom treatment with at least one class IA antiarrhythmic agent had failed.

Interventions: Patients were treated with encainide, 35 to 50 mg three or four times daily, or flecainide, 100 to 200 mg twice daily.

Results: Arrhythmia worsened early in 5 of 16 patients receiving encainide and 3 of 33 patients receiving flecainide. Patients with poor left ventricular function were more likely to exhibit proarrhythmia (P = 0.02). Nine of eleven patients receiving encainide and 23 of 28 patients receiving flecainide who had repeat programmed ventricular stimulation while receiving drug therapy still had inducible, poorly tolerated ventricular tachycardia.

Conclusion: Encainide and flecainide have a low efficacy rate and a high incidence of worsening of arrhythmia in patients with sustained ventricular arrhythmias, particularly when this condition is associated with poor left ventricular function.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Journal Club
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)