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Influence of left ventricular dysfunction on flecainide therapy
Journal article   Open access   Peer reviewed

Influence of left ventricular dysfunction on flecainide therapy

Angelo A.V. de Paola, Leonard N. Horowitz, Joel Morganroth, Sheila Senior, Scott R. Spielman, Allan M. Greenspan and Harold R. Kay
Journal of the American College of Cardiology, v 9(1), pp 163-168
Jan 1987
DOI: https://doi.org/10.1016/S0735-1097(87)80096-7
PMID: 3098817
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/s0735-1097(87)80096-7View
Published, Version of Record (VoR) Open

Abstract

Seventy-six patients with ventricular tachyarrhythmias (40 sustained and 36 nonsustained) were treated with oral flecainide. Radionuclide left ventricular ejection fraction was 30% or less in 33 patients and greater than 30% in 43 patients. Before flecainide, compensated heart failure was present in 23 patients (ejection fraction ≤ 30% in 15 and > 30% in 8). Flecainide mean dose was 150 mg twice daily and mean plasma concentration was 720 ng/ml. New or worsened congestive heart failure occurred in seven patients on flecainide therapy, all with an ejection fraction of less than 30%; six had a previous history of compensated heart failure and of these, three died. Ejection fraction was the only independent variable that significantly influenced efficacy and tolerance of flecainide. After 1 year of therapy, efficacy and tolerance was 58% (25 of 43) in patients with an ejection fraction greater than 30% and 12% (4 of 33) in patients with an ejection fraction of 30% or less (p < 0.001). Thus, congestive heart failure can occur during flecainide therapy, particularly in patients with a previous history of congestive heart failure and ejection fraction of less than 30%, and may particularly limit therapy in these patients. Clinical efficacy and tolerance were significantly lower in patients with an ejection fraction of less than 30%.

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Web of Science research areas
Cardiac & Cardiovascular Systems
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