Encainide and its metabolites. Comparative effects in man on ventricular arrhythmia and electrocardiographic intervals.
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Why the study?
Does encainide and its active metabolites suppress ventricular arrhythmias and prolong electrocardiographic intervals in patients with resistant ventricular ectopic depolarizations?
Population
8 patients with stable, high frequency ventricular ectopic depolarizations resistant to conventional…
Comparison
Encainide administered as an acute intravenous… vs Baseline.
Design
Cohort, Interval measurements and arrhythmia frequency analysis were performed…
Follow-up
Acute (hours) and sustained oral therapy (at least 4 days)
Authors
Discussion
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Implication
Encainide effects vary by metabolizer phenotype; supports pharmacogenetic research but should not yet change practice.
Structured PICO
Does encainide and its active metabolites suppress ventricular arrhythmias and prolong electrocardiographic intervals in patients with resistant ventricular ectopic depolarizations?
P
Population
8 patients (6 extensive metabolizers, 2 poor metabolizers) with stable, high frequency ventricular ectopic depolarizations (VED) resistant to conventional antiarrhythmic agents. Age range 51 to 73 years, 6 male and 2 female.
I
Intervention
Encainide administered as an acute intravenous infusion (0.8 mg/kg over 20 min) and as sustained oral therapy (maintenance dosage for at least 4 days).
C
Comparator
Baseline (patients observed off antiarrhythmic therapy for at least 48 hours or 4 half-lives).
O
Outcome
Arrhythmia suppression (VED frequency) and electrocardiographic interval changes (QRS, QTc prolongation) correlated with plasma concentrations of encainide and its metabolites.surrogate
Encainide's antiarrhythmic and electrocardiographic effects are primarily mediated by its active metabolite ODE in extensive metabolizers, while the parent drug is active at high concentrations in poor metabolizers.
Limitations
- Small sample size (n=8)
Cite This Study
Carey et al. (1984) studied this question.
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