What question did this study set out to answer?

To evaluate the antiarrhythmic efficacy and potential proarrhythmic risks of encainide and flecainide in patients suffering from sustained ventricular arrhythmias.

November 1, 1990Annals of Internal Medicine

Inefficacy and Proarrhythmic Effects of Flecainide and Encainide for Sustained Ventricular Tachycardia and Ventricular Fibrillation

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Why the study?

Do encainide and flecainide improve the results of programmed ventricular stimulation in patients with sustained ventricular arrhythmias who failed class IA agents?

Population

49 patients with spontaneous or inducible sustained ventricular tachycardia or ventricular fibrillation for…

Comparison

Encainide or flecainide. vs Drug-free baseline.

Design

Cohort

Authors

JHJohn M. HerreOld Dominion University

Discussion

Member takes

Implication

May not suppress inducible VT or risks proarrhythmia; leaves open class IC utility after class IA failure in refractory cases.

Key Points

To evaluate the antiarrhythmic efficacy and potential proarrhythmic risks of encainide and flecainide in patients suffering from sustained ventricular arrhythmias.
Assessed 49 patients with spontaneous or inducible sustained ventricular tachycardia or ventricular fibrillation who previously failed treatment with at least one class IA antiarrhythmic agent.
Administered oral encainide (35 to 50 mg three or four times daily) or flecainide (100 to 200 mg twice daily) and compared programmed ventricular stimulation findings on therapy versus drug-free baseline.
Early worsening of arrhythmia occurred in 5 of 16 patients (31.3%) taking encainide and 3 of 33 patients (9.1%) taking flecainide, with proarrhythmia significantly more common in patients with poor left ventricular function (P = 0.02).
During repeat programmed ventricular stimulation on drug therapy, 9 of 11 patients receiving encainide and 23 of 28 patients receiving flecainide continued to exhibit inducible, poorly tolerated ventricular tachycardia.

Structured PICO

Do encainide and flecainide improve the results of programmed ventricular stimulation in patients with sustained ventricular arrhythmias who failed class IA agents?

Population

49 patients with spontaneous or inducible sustained ventricular tachycardia or ventricular fibrillation for whom treatment with at least one class IA antiarrhythmic agent had failed.

Intervention

Encainide (35 to 50 mg three or four times daily) or flecainide (100 to 200 mg twice daily).

Comparator

Drug-free baseline.

Outcome

Results of programmed ventricular stimulation (inducibility of poorly tolerated ventricular tachycardia) and early worsening of arrhythmia.surrogate

Encainide and flecainide demonstrate low efficacy and significant proarrhythmic effects in patients with refractory sustained ventricular arrhythmias, especially those with poor left ventricular function.

Cite This Study

John M. Herre (1990) studied this question.

synapsesocial.com/papers/6a7fa18e044998269cd76ff1 https://doi.org/10.7326/0003-4819-113-9-671

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Inefficacy and Proarrhythmic Effects of Flecainide and Encainide for Sustained Ventricular Tachycardia and Ventricular Fibrillation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Inefficacy and Proarrhythmic Effects of Flecainide and Encainide for Sustained Ventricular Tachycardia and Ventricular Fibrillation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider