Advertisement

Intensive Care Medicine

, Volume 20, Issue 1, pp 42–44 | Cite as

Efficacy of flecainide in patients with supraventricular arrhythmias and respiratory insufficiency

  • F. Barranco
  • M. Sanchez
  • J. Rodriguez
  • M. Guerrero
Brief Reports

Abstract

Objective

Evaluation of efficacy of intravenous flecainide to revert supraventricular arrhythmias to sinus rhythm in patients with respiratory insufficiency.

Design

Comparative randomized prospective trial.

Setting

ICU in a University Hospital

Patients

30 patients with acute respiratory insufficiency or acute exscerbation of chronic respiratory insufficiency and supraventricular arrhythmias. Intravenous flecainide was administered to 15 patients (Group A) (2 mg/kg for 10 min and continuous perfusion of 1.5 mg/kg for 1 h). Intravenous verapamil was administered to 15 patients (Group B) (0.15 mg/kg for 5 min and continuous perfusion of 0.005 mg/kg/min for 1 h).

Measurements and results

The categories of patients' arrhythmias were: Group A — atrial fibrillation (AF) in 5 cases, atrial flutter (AFl) in 2, multifocal atrial tachycardia (MAT) in 4 and other supraventricular tachycardia (SVT) in 4. Group B — AF in 6 cases, AFL in 2, MAT in 2 and SVT in 5 cases. Flecainide reverted arrhythmias to sinus rhythm in 12 out of 15 cases (80%); of these 12, 11 reverted with the initial bolus. Verapamil reverted 5 out of 12 cases (33.3%,p<0.01). No significant secondary adverse effects were detected.

Conclusion

Intravenous flecainide is an effective antiarrhythmic drug to treat acute supraventricular arrhythmias in patients with respiratory insufficiency.

Key words

Flecainide Supraventricular arrhythmias Respiratory insufficiency 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Hudson L, Kurt T, Petty T, Genton E (1973) Arrhythmias associated with acute respiratory failure in patients with chronic airway obstruction. Chest 63:661–665PubMedGoogle Scholar
  2. 2.
    Holford F, Mithoefer J (1973) Cardiac arrhythmias in hospitalized patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 108:879–885PubMedGoogle Scholar
  3. 3.
    Johanson W, Peters J (1988) Complications and philosophy. In: Murray J, Nadel J (eds) Textbook of respiratory medicine. Saunders, Philadelphia, pp 2035–2054Google Scholar
  4. 4.
    Smith W, Gallagher J (1986) Mechanisms of arrhythmias and conduction abnormalities. In: Hurst J (ed) The heart. McGraw-Hill, Baskerville, pp 406–432Google Scholar
  5. 5.
    Edwards JD (1986) Management of intractable supraventricular arrhythmias in the ICU. In: Vincent JL (ed) Update in intensive care and emergency medicine. Springer, Berlin Heidelberg New York Tokyo, pp 169–171Google Scholar
  6. 6.
    Berns E, Rinkenberger R, Jeang M, Dougherty A, Jenkins M, Naccarelli G (1987) Efficacy and safety of flecainide acetate for atrial tachycardia or fibrillation. Am J Cardiol 59:1337–1341PubMedCrossRefGoogle Scholar
  7. 7.
    Hellestrand K (1988) Intravenous flecainide acetate for supraventricular tachycardias. Am J Cardiol 62:16D-22DPubMedCrossRefGoogle Scholar
  8. 8.
    Barranco F, Blasco J, Lesmes A (1990) Eficacia de la Flecainida en las arritmias supraventriculares en el curso de la insuficiencia respiratoria aguda. Med Intens 24:363–366Google Scholar
  9. 9.
    Ferrando C, Cabades A, Castro J, Rucabado L, Quintana O, Ruano M (1980) Amiodarona endovenosa en el tratamiento de arritmias supraventriculares. Med Intens 4:116–119Google Scholar
  10. 10.
    Arsura E, Lefkin A, Scher D, Solar M (1988) A randomized, double-blind, placebo-controlled study of verapamil and metoprolol in treatment of multifocal atrial tachycardia. Am J Cardiol 85:519–524Google Scholar
  11. 11.
    Roden D, Woosley R (1986) Drug therapy. Flecainide. N Engl J Med 315:36–41PubMedCrossRefGoogle Scholar
  12. 12.
    The Cardiac Arrhythmia Suppression Trial (CAST) investigators (1989) Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 321:406–412CrossRefGoogle Scholar
  13. 13.
    Flecainide and CAST (Editorial) (1989) Lancet II:481–482Google Scholar
  14. 14.
    Pritchett E, Wilkinson W (1991) Mortality in patients treated with flecainide and encainide for supraventricular arrhythmias. Am J Cardiol 67:976–980PubMedCrossRefGoogle Scholar
  15. 15.
    Scher D, Arsura E (1989) Multifocal atrial tachycardia: Mechanisms, clinical correlates, and treatment. Am Heart J 118:574–580PubMedCrossRefGoogle Scholar
  16. 16.
    Roden D (1988) Role of the electrocardiogram in determining electrophysiologic end points of drug therapy. Am J Cardiol 62:34H-38HPubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • F. Barranco
    • 1
  • M. Sanchez
    • 1
  • J. Rodriguez
    • 1
  • M. Guerrero
    • 1
  1. 1.Department of Intensive MedicineValme Universitary HospitalSevillaSpain

Personalised recommendations