Recent studies suggest flecainide may have good effectiveness and safety in patients with different structural heart diseases, prompting a reassessment of its use 30 years after CAST.
Is flecainide safe and effective for the treatment of ventricular arrhythmias in patients with structural heart disease?
This review highlights emerging evidence that flecainide may be safe and effective for ventricular arrhythmias in patients with structural heart disease, potentially challenging historical restrictions based on the CAST trial.
Flecainide is an IC antiarrhythmic drug (AAD) that received in 1984 Food and Drug Administration approval for the treatment of sustained ventricular tachycardia (VT) and subsequently for rhythm control of atrial fibrillation (AF). Currently, flecainide is mainly employed for sinus rhythm maintenance in AF and the treatment of idiopathic ventricular arrhythmias (IVA) in absence of ischaemic and structural heart disease on the basis of CAST data. Recent studies enrolling patients with different structural heart diseases demonstrated good effectiveness and safety profile of flecainide. The purpose of this review is to assess current evidence for appropriate and safe use of flecainide, 30 years after CAST data, in the light of new diagnostic and therapeutic tools in the field of ischaemic and non-ischaemic heart disease.
Lavalle et al. (Fri,) conducted a review in Ventricular arrhythmias and atrial fibrillation. Flecainide was evaluated. Recent studies suggest flecainide may have good effectiveness and safety in patients with different structural heart diseases, prompting a reassessment of its use 30 years after CAST.
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