Why the study?
Guidelines limit flecainide use based on increased post-MI mortality in CAST, but subsequent studies suggested safety in other structural heart diseases.
Does flecainide increase the incidence of ventricular arrhythmias in patients with structural heart disease compared to those with a normal heart?
Population
336 patients who received at least one dose of flecainide
Comparison
Patients with structural heart disease vs those with a normal heart
Design
Retrospective cohort study
Follow-up
1 year
Authors
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No excess VA risk seen with flecainide in structural heart disease; hypothesis-generating and should not yet change practice.
Does flecainide increase the incidence of ventricular arrhythmias in patients with structural heart disease compared to those with a normal heart?
In this retrospective cohort, flecainide use in patients with structural heart disease was not associated with a significantly increased risk of ventricular arrhythmias at 1 year compared to patients with normal hearts.
Sangpornsuk et al. (2025) studied this question.
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