Effect of encainide and flecainide on chronic ectopic atrial tachycardia

In the treatment of chronic ectopic atrial tachycardia, standard antiarrhythmic therapy has been shown to be ineffective in the majority of patients. The intravenous and oral effects of two class IC antiarrhythmic drugs, encainide and flecainide, in five patients with chronic ectopic atrial tachycar...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 1986-05, Vol.7 (5), p.1121-1126
Main Authors: Kunze, Klaus-Peter, Kuck, Karl-Heinz, Schlüter, Michael, Bleifeld, Walter
Format: Article
Language:English
Subjects:
Adult
Anilides - administration & dosage
Anilides - therapeutic use
Antiarythmic agents
Biological and medical sciences
Cardiovascular system
Chronic Disease
Electrophysiology
Encainide
Female
Flecainide
Heart Atria - physiopathology
Humans
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Piperidines - administration & dosage
Piperidines - therapeutic use
Tachycardia - drug therapy
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Summary:In the treatment of chronic ectopic atrial tachycardia, standard antiarrhythmic therapy has been shown to be ineffective in the majority of patients. The intravenous and oral effects of two class IC antiarrhythmic drugs, encainide and flecainide, in five patients with chronic ectopic atrial tachycardia were studied using exercise testing, 24 hour long-term electrocardiography and programmed electrical stimulation. All patients had been treated unsuccessfully with at least four antiarrhythmic drugs. In two patients tachycardia was persistent, and in three patients tachycardia occurred intermittently for more than 12 hours/day. Intravenous encainide and flecainide at doses ranging from 0.3 to 2.0 mg/kg and from 0.5 to 1.5 mg/kg body weight, respectively, terminated atrial ectopic tachycardia in all patients. Oral encainide, 150 to 225 mg/day, completely suppressed ectopic atrial activity in four patients during a mean follow-up period of 8 ± 3 months. In the remaining patient encainide markedly reduced the number of episodes of tachycardia. In three patients encainide had to be withdrawn because of intolerable side effects. These patients were well controlled with oral flecainide, 200 to 300 mg/day, without side effects. On the basis of these results, the efficacy of encainide and flecainide in the treatment of chronic ectopic atrial tachycardia appears to be not drug-specific but rather a general class IC property.
ISSN:0735-1097
1558-3597
DOI:10.1016/S0735-1097(86)80233-9