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Comparison Between Flecainide and Atenolol in the Suppression of Complex Ventricular Ectopic Activity After Myocardial Infarction: Results of a Double‐Blind, Randomized Trial
Author(s) -
CRIPPS TIM,
MANNERING DAVID,
BENNETT DAVID
Publication year - 1988
Publication title -
journal of electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 0892-1059
DOI - 10.1111/j.1540-8167.1988.tb01489.x
Subject(s) - atenolol , medicine , flecainide , cardiology , ventricular tachycardia , myocardial infarction , anesthesia , randomized controlled trial , tachycardia , atrial fibrillation , blood pressure
The efficacy of flecainide (100–150 mg bd) in comparison with atenolol (50–100 mg bd) in suppressing frequent (5/hour) ventricular ectopic activity and nonsustained ventricular tachycardia on ambulatory monitoring was assessed in 26 patients one month after myocardial infarction in a randomized, double‐blind trial. Blood drug levels were monitored and monthly follow‐up ambulatory monitoring and exercise testing were performed for three months, A successful response (70% suppression of ectopic activity or elimination of ventricular tachycardia) was seen in 100% of patients randomized to flecainide compared with 50% randomized to atenolol (p<.05). Three patients developed serious adverse reactions to treatment, one of whom was receiving flecainide and the other two atenolol. The patient on flecainide suffered an exacerbation of heart failure; one on atenolol experienced bronchospasm and the other a proarrhythmic effect. Flecainide is superior to atenolol in the suppression of ventricular ectopics and nonsustained ventricular tachycardia in patients with recent myocardial infarction, though should be used with care in patients with critically impaired left ventricular function.