Skip to main content
SpringerLink
Log in

Effect of Flecainide on Heart Rate Variability in Subjects Without Coronary Artery Disease or Congestive Heart Failure

  • Published:
Cardiovascular Drugs and Therapy Aims and scope Submit manuscript

Abstract

Heart rate variability is a noninvasive indicator of autonomic nervous system activity. The role of the autonomic nervous system in the genesis of atrial or ventricular arrhythmias is now well established. Little is known about the effects of flecainide on heart rate variability in patients with normal heart structure, the main population receiving flecainide. This study was designed to evaluate the effects of flecainide on heart rate variability in patients without coronary artery disease or congestive heart failure. Time and frequency domain analysis of heart rate variability on 24-hour electrocardiogram recording were assessed in 40 patients with normal echocardiography and without evidence of coronary artery disease before and after 2 months of oral treatment with flecainide (321 ± 57 mg/day) prescribed for Wolff Parkinson White syndrome with circus movement tachycardia. Flecainide significantly decreased all parameters of heart rate variability in the time domain (median Δ% −10% to −25%) and in the frequency domain (median Δ% −27% to −38%), including the markers of vagal activity. There was no correlation between plasma concentrations of flecainide and reduction in heart rate variability. It was concluded that in subjects without coronary artery disease or congestive heart failure, flecainide decreases all the measurements of heart rate variability and this decrease is not related to plasma concentrations of flecainide.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability. Standards of measurements, physiological interpretation, and clinical use. Circulation 1996;93: 1043-1065.

    Google Scholar 

  2. Malliani A, Pagani M, Lombardi F, Cerutti S. Cardiovascular neural regulation explored in the frequency domain. Circulation 1991;84:482-492.

    Google Scholar 

  3. Kleiger RE, Miller JP, Bigger JT Jr. et al. Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 1987; 59:256-262.

    Google Scholar 

  4. Bigger JT Jr., Fleiss JL, Steinman RC, Rolnitzky LM, Kleiger RE, Rottman JN. Frequency domain of heart period variability and mortality after myocardial infarction. Circulation 1992;85:164-171.

    Google Scholar 

  5. Cripps TR, Malik M, Farrell TG, Camm AJ. Prognostic value of reduced heart rate variability after myocardial infarction: Clinical evaluation of a new analysis method. Br Heart J 1991;65:14-19.

    Google Scholar 

  6. Algra A, Tijssen JG, Roelandt JR, Pool J, Lubsen J. Heart rate variability from 24-hour electrocardiography and the 2-year risk for sudden death. Circulation 1993;88:180-185.

    Google Scholar 

  7. Fei L, Anderson MH, Katritsis D, Sneddon J, Statters DJ, Malik M, Camm AJ. Decreased heart rate variability in survivors of sudden cardiac death not associated with coronary artery disease. Br Heart J 1994;71:16-21.

    Google Scholar 

  8. Coumel P. Neural aspects of paroxysmal atrial fibrillation. In Falk RH, Podrid PJ, eds. Atrial Fibrillation: Mechanisms and Management. New York: Raven Press, 1992:109-125.

    Google Scholar 

  9. Coumel P, Leenhardt A, Leclercq JF. Autonomic influences on ventricular arrhythmias in myocardial hypertrophy and heart failure. Circulation 1993;87(Suppl. VII):VII84-VII91.

    Google Scholar 

  10. Sandrone G, Mortara A, Torzillo D, La Rovere MT, Malliani A, Lombardi F. Effects of beta blockers (atenolol or metoprolol) on heart rate variability after acute myocardial infarction. Am J Cardiol 1994;74:340-345.

    Google Scholar 

  11. Molgaard H, Mickley H, Pless P, Bjerregaard P, Moller M. Effects of metoprolol on heart rate variability in survivors of acute myocardial infarction. Am J Cardiol 1993;71: 1357-1359.

    Google Scholar 

  12. Pousset F, Copie X, Lechat P, et al. Effects of bisoprolol on heart rate variability in heart failure. Am J Cardiol 1996;77: 612-617.

    Google Scholar 

  13. Cook JR, Bigger JT Jr., Kleiger RE, Fleiss JL, Steinman RC, Rolnitzky LM. Effect of atenolol and diltiazem on heart period variability in normal persons. J Am Coll Cardiol 1991;17:480-484.

    Google Scholar 

  14. Lombardi F, Torzillo D, Sandrone G, et al. Beta-blocking effect of propafenone based on spectral analysis of heart rate variability. Am J Cardiol 1992;70:1028-1034.

    Google Scholar 

  15. Antimisiaris M, Sarma JS, Schoenbaum MP, Sharma PP, Venkataraman K, Singh BN. Effects of amiodarone on the circadian rhythm and power spectral changes of heart rate and QT interval: Significance for the control of sudden cardiac death. Am Heart J 1994;128:884-891.

    Google Scholar 

  16. Hohnloser SH, Klingenheben T, Zabel M, Just H. Effect of sotalol on heart rate variability assessed by Holter monitoring in patients with ventricular arrhythmias. Am J Cardiol 1993;72:67A-71A.

    Google Scholar 

  17. Bigger JT Jr., Rolnitzky LM, Steinman RC, Fleiss JL. Predicting mortality after myocardial infarction from the response of RR variability to antiarrhythmic drug therapy. J Am Coll Cardiol 1994;23:733-740.

    Google Scholar 

  18. Akhtar M, Breithardt G, Camm AJ, et al. CAST and beyond. Implications of the Cardiac Arrhythmia Suppression Trial. Task Force of the Working Group on Arrhythmias of the European Society of Cardiology. Circulation 1990;81: 1123-1127.

    Google Scholar 

  19. Josephson MA, Ikeda N, Singh BN. Effects of flecainide on ventricular function: Clinical and experimental correlations. Am J Cardiol 1984;53:95B-100B.

    Google Scholar 

  20. Falk RH, Fogel RI. Flecainide. J Cardiovasc Electrophysiol 1994;5:964-981.

    Google Scholar 

  21. Zuanetti G, Ewing DJ, Schwartz PJ, Neilson JM, Latini R. Heart rate variability in patients with ventricular arrhythmias: Effect of antiarrhythmic drugs. Antiarrhythmic Drug Evaluation Group (ADEG). J Am Coll Cardiol 1991; 17:604-612.

    Google Scholar 

  22. Myerburg RJ, Kessler KM, Cox MM, et al. Reversal of proarrhythmic effects of flecainide acetate and encainide hydrochloride by propranolol. Circulation 1989;80: 1571-1579.

    Google Scholar 

  23. Alboni P, Paparella N, Cappato R, Candini G. Direct and autonomically mediated effects of oral flecainide. Am J Cardiol 1988;61:759-763.

    Google Scholar 

  24. Pritchett EL, Hougham AJ, McCarville SE, Platt ML, Da-Torre SD. Flecainide acetate treatment of paroxysmal supraventricular tachycardia and paroxysmal atrial fibrillation: Dose-response studies. The Flecainide Supraventricular Tachycardia Study Group. J Am Coll Cardiol 1991;17: 297-303.

    Google Scholar 

  25. Padrini R, Ferrari M, Maiolino P, al-Bunni M, Busa M, Piovan D. Pharmacodynamic variability of flecainide assessed by QRS changes. Clin Pharmacol Ther 1993; 53:59-64.

    Google Scholar 

  26. Malik M, Camm AJ. Components of heart rate variability-What they really mean and what we really measure. Am J Cardiol 1993;72:821-822.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service de Cardiologie B et Laboratoire d'électrophysiologie cardiaque, Centre Hospitalier Universitaire Trousseau, Tours, France

    Laurent Fauchier, Dominique Babuty, Marie Laurence Autret, Philippe Poret, Pierre Cosnay & Jean Paul Fauchier

Authors
  1. Laurent Fauchier
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dominique Babuty
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marie Laurence Autret
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Philippe Poret
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pierre Cosnay
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jean Paul Fauchier
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fauchier, L., Babuty, D., Autret, M.L. et al. Effect of Flecainide on Heart Rate Variability in Subjects Without Coronary Artery Disease or Congestive Heart Failure. Cardiovasc Drugs Ther 12, 483–486 (1998). https://doi.org/10.1023/A:1007710301259

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1007710301259

Search

Navigation