Key result
Treatment with flecainide, mexiletine, and beta blockers in a patient with MEPPC syndrome reduced PVCs from 44% to 1% and improved left ventricular ejection fraction from 44% to 53%.
Why the study?
A lack of defined diagnostic criteria hampers timely diagnosis of MEPPC syndrome, leading to ineffective interventions and delayed initiation of antiarrhythmic drugs while patients remain at risk for severe heart failure and sudden cardiac death.
Does combination therapy with flecainide, mexiletine, and beta blockers improve PVC burden and LV function in a patient with MEPPC syndrome?
Case Report (n=1)
Does combination therapy with flecainide, mexiletine, and beta blockers improve PVC burden and LV function in a patient with MEPPC syndrome?
Combination therapy with flecainide, mexiletine, and beta blockers effectively reduced PVC burden and restored LV function in a patient with MEPPC syndrome.
, p.(Arg814Trp), confirming the diagnosis of MEPPC syndrome. Treatment with a combination of class I antiarrhythmic drugs, flecainide and mexiletine, concomitant with beta blockers, led to symptomatic improvement, a reduction of PVCs (from 66 491 (44%) to 858 (1%)), and the restoration of left ventricular function (LV EF from 44% to 53%). A lack of defined diagnostic criteria hampers timely diagnosis, leading to ineffective interventions and delayed initiation of treatment with antiarrhythmic drugs. MEPPC patients remain at significant risk for severe heart failure and sudden cardiac death. Our clinical case report underscores the importance of accurate and timely diagnosis, which allows effective treatment with a combination of antiarrhythmic drugs and mitigates the risk associated with MEPPC syndrome.
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Keževičiūtė et al. (2025) conducted a case report in Multifocal Ectopic Purkinje-Related Premature Contractions (MEPPC) Syndrome (n=1). Flecainide, mexiletine, and beta blockers was evaluated on Premature ventricular contractions (PVCs) burden and left ventricular ejection fraction (LVEF). Treatment with flecainide, mexiletine, and beta blockers in a patient with MEPPC syndrome reduced PVCs from 44% to 1% and improved left ventricular ejection fraction from 44% to 53%.
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