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Efficacy of flecainide in patients with supraventricular arrhythmias and respiratory insufficiency

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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.

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Authors and Affiliations

  1. Department of Intensive Medicine, Valme Universitary Hospital, Sevilla, Spain

    F. Barranco, M. Sanchez, J. Rodriguez & M. Guerrero

Authors
  1. F. Barranco
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  2. M. Sanchez
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  3. J. Rodriguez
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  4. M. Guerrero
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Barranco, F., Sanchez, M., Rodriguez, J. et al. Efficacy of flecainide in patients with supraventricular arrhythmias and respiratory insufficiency. Intensive Care Med 20, 42–44 (1994). https://doi.org/10.1007/BF02425054

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  • DOI: https://doi.org/10.1007/BF02425054

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