| Flecainide therapy reduces exercise-induced ventricular arrhythmias in patients with catecholaminergic polymorphic ventricular tachycardia. | |
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MedLine Citation:
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PMID: 21616285 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This study evaluated the efficacy and safety of flecainide in addition to conventional drug therapy in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT). BACKGROUND: CPVT is an inherited arrhythmia syndrome caused by gene mutations that destabilize cardiac ryanodine receptor Ca(2+) release channels. Sudden cardiac death is incompletely prevented by conventional drug therapy with β-blockers with or without Ca(2+) channel blockers. The antiarrhythmic agent flecainide directly targets the molecular defect in CPVT by inhibiting premature Ca(2+) release and triggered beats in vitro. METHODS: We collected data from every consecutive genotype-positive CPVT patient started on flecainide at 8 international centers before December 2009. The primary outcome measure was the reduction of ventricular arrhythmias during exercise testing. RESULTS: Thirty-three patients received flecainide because of exercise-induced ventricular arrhythmias despite conventional (for different reasons, not always optimal) therapy (median age 25 years; range 7 to 68 years; 73% female). Exercise tests comparing flecainide in addition to conventional therapy with conventional therapy alone were available for 29 patients. Twenty-two patients (76%) had either partial (n = 8) or complete (n = 14) suppression of exercise-induced ventricular arrhythmias with flecainide (p < 0.001). No patient experienced worsening of exercise-induced ventricular arrhythmias. The median daily flecainide dose in responders was 150 mg (range 100 to 300 mg). During a median follow-up of 20 months (range 12 to 40 months), 1 patient experienced implantable cardioverter-defibrillator shocks for polymorphic ventricular arrhythmias, which were associated with a low serum flecainide level. In 1 patient, flecainide successfully suppressed exercise-induced ventricular arrhythmias for 29 years. CONCLUSIONS: Flecainide reduced exercise-induced ventricular arrhythmias in patients with CPVT not controlled by conventional drug therapy. |
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Authors:
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Christian van der Werf; Prince J Kannankeril; Frederic Sacher; Andrew D Krahn; Sami Viskin; Antoine Leenhardt; Wataru Shimizu; Naokata Sumitomo; Frank A Fish; Zahurul A Bhuiyan; Albert R Willems; Maurits J van der Veen; Hiroshi Watanabe; Julien Laborderie; Michel Haïssaguerre; Björn C Knollmann; Arthur A M Wilde |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 57 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-05-27 Completed Date: 2011-08-11 Revised Date: 2012-02-28 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 2244-54 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiology, Heart Failure Research Center, Academic Medical Center, Amsterdam, the Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Anti-Arrhythmia Agents / administration & dosage, pharmacology, therapeutic use* Arrhythmias, Cardiac / prevention & control* Child Defibrillators, Implantable Dose-Response Relationship, Drug Exercise Test Female Flecainide / administration & dosage, pharmacology, therapeutic use* Humans Male Middle Aged Retrospective Studies Tachycardia, Ventricular / drug therapy Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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HL076264/HL/NHLBI NIH HHS; HL71670/HL/NHLBI NIH HHS; HL88635/HL/NHLBI NIH HHS; R01 HL071670-09/HL/NHLBI NIH HHS; R01 HL088635-06/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anti-Arrhythmia Agents; 54143-55-4/Flecainide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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