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Flecainide: PVC Reduction in Children with Ventricular Dysrhythmias
Author(s) -
HAYS MARK D.,
GILLETTE PAUL C.,
ZIEGLER VICKI,
ATKINS JOHN,
ROSS BERTRAND A.,
BUCKLES DAVID S.
Publication year - 1989
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.1540-8167.1989.tb01557.x
Subject(s) - flecainide , medicine , cardiology , anesthesia , ventricular tachycardia , ambulatory , refractory (planetary science) , tachycardia , atrial fibrillation , physics , astrobiology
Flecainide appears to be a promising new Class I c antiarrhythmic drug. In this study, 16 children aged 18 days to 20 years (mean 8.0 years, median 6.8 years) with frequent PVCs and refractory ventricular tachycardia (VT) were evaluated. In all patients, a mean total of 3.5 antiarrhythmic agents were tried unsuccessfully prior to initiation of flecainide. We performed 24‐hour ambulatory monitoring 2 days prior to oral flecainide administration and repeated monitoring after 48 hours of oral therapy. All studies were scanned by superimposition by computer and well‐trained technician. Twelve of 16 children demonstrated reduced numbers of PVCs following oral flecainide therapy with an overall mean reduction in PVCs of 70%. Mean numbers of PVCs fell from 377 PVCs/hour preflecainide to 113 PVCs/hour postflecainide therapy. Eight of 12 patients demonstrated a > 60% reduction of PVCs. Five of 12 children achieved nearly total abolishment of PVCs (e.g., <10 PVCs/hour) following flecainide treatment. Four of 16 children failed to exhibit PVC reduction during the study. Serum flecainide levels ranged from 0.1–1.1 meg/mL with a mean drug level of 0.39 mcg/mL. Success or failure did not correlate significantly with patient age, sex, anatomic diagnosis, previous therapy, or serum flecainide levels. In summary, oral flecainide appears to be effective in reducing PVCs in children with ventricular tachycardia and consequently may decrease their risk for reentrant VT.