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Long term inotropic effects of flecainide and propafenone

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Abstract

This study was undertaken to evaluate the effect of flecainie (Fle) and propafenone (Pro) on rest and exercise myocardial contractility after prolonged oral administration. Standardized, fully automated, gated radionuclide angiograms at rest and during maximum excercise were performed single blinded and prospectively in 19 patients before and after oral treatment with either 150 mg b.i.d. of Fle or 150 mg t.i.d. of Pro. The left ventricular ejection fraction (EF %) as a hemodynamic indicator presented as follows:

In general, there was no significant effect of either drug on resting ventricular function. In only one patient of the Fle group with decreased baseline function did the left ventricular EF fall from 40% to 29%. During exercise, ventricular performance showed deterioration in the Pro group, but, interestingly, improvement in the Fle group. As a result of these opposite changes, the effect of the two drugs on the exercise response of ventricular function was significantly different (P<0.05). This study thus gives first evidence that no significant cardiodepressive effects are to be expected after prolonged application of Fle or Pro in normal hearts. There might even be a mild benefical effect on exercise performance after Fle.

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References

  • Angermann C, Jahrmärker H (1983) Vergleichende Untersuchungen zur kardiodepressorischen Wirkung von Disopyramid, Mexiletin und Propafenon. Z Kardiol 72:665–670

    PubMed  CAS  Google Scholar 

  • Beck OA, Vogt J, Hochrein H (1978) Der Einfluß von Antiarrhythmika auf die Hämodynamik bei akutem Myokardinfarkt. Z Kardiol 67:41–46

    PubMed  CAS  Google Scholar 

  • Bender F, Crohnheim G (eds) (1984) Flecainid. Gustav Fischer, Stuttgart New York

    Google Scholar 

  • Bramann HU, Bender F, Große-Heitmeyer W (1984) Langzeittherapie mit Flecaninide. Z Kardiol 73:724–731

    PubMed  CAS  Google Scholar 

  • Flowers D, O-Gallagher D, Torres V, Miurad D, Somberg JV (1985) Flecainide: long-term treatment using a reduced dosing schedule. Am J Cardiol 55:79–83

    Article  PubMed  CAS  Google Scholar 

  • Henze E, Tymiec A, Delagardelle C, Adam WE, Stauch M (1986 a) Improved specification of regional wall motion abnormalities by phase analysis of radionuclide angiograms in CAD and nonCAD patients. J Nucl Med 27:781–786

    PubMed  CAS  Google Scholar 

  • Henze E, Bitter F, Weller R, Stauch M (1986b) Phasen- und Amplitudenanalyse zur Spezifizierung regionaler Wandbewegungsstörungen in der Radionuklid-Ventrikulographie. Der Nuklearmediziner 9:3–13

    Google Scholar 

  • Hodges M (1984) Die Wirkung von Flecainid auf hämodynamische Parameter in Probanden und in herzkranken Patienten. In: Flecainid — Experimentelle Befunde und klinische Erfahrungen. Bender F, Cronheim G (Hrsg) Stuttgart New York, Fischer, 2. Auflage, pp 59–69

    Google Scholar 

  • Hodges M, Haughland JM, Granrud G, Asinger RW, Mikell FL, Kreijci J (1982) Suppression of ventricular ectopic depolarizations by flecainide acetate, a new antiarrhythmic agent. Circulation 65:879–885

    PubMed  CAS  Google Scholar 

  • Holtzman JL, Berry DA, Kvam DC, Mottonen L, Borrel G (1984) Application of second-order polynomial equations to the study of pharmacodynamic interactions: the effect of flecainide acetate and propranolon on cardiac output and vascular resistance. J Pharmacol Exp Ther 231:286–289

    PubMed  CAS  Google Scholar 

  • Josephson MA, Ikeda N, Singh BN (1984) Effects of flecainide on ventricular function: clinical and experimental correlations. Am J Cardiol 53: 95 B

    Article  CAS  Google Scholar 

  • Josephson MA, Kaul S, Hopkins J, Kvam D, Singh BN (1985) Hemodynamic effects of intravenous flecainide relative to the level of ventricular function in patients with coronary artery disease. Am Heart J 109:41–45

    Article  PubMed  CAS  Google Scholar 

  • Legrand V, Vandormael M, Collignon P, Kulbertus HE (1983) Hemodynamic effects of a new antiarrhythmic agent, flecainide (R-818), in coronary heart disease. Am J Cardiol 51:422–426

    Article  PubMed  CAS  Google Scholar 

  • Lown B, Graboys TB (1977) Malignant ventricular arrhythmias. Am J Cardiol 39:912–922

    Google Scholar 

  • Marshall RC, Wisenberg G, Schelbert HR, Henze E (1981) Effect of oral propranolol on rest, exercise and postexercise left ventricular performance in normals and in patients with coronary artery disease. Circulation 63:572–583

    PubMed  CAS  Google Scholar 

  • Podrid PJ, Lown B (1984) Propafenone: a new agent for ventricular arrhythmia. J Am Coll Cardiol 4:117–126

    Article  PubMed  CAS  Google Scholar 

  • Serruys PW, Vanhaleweyk G, Van den Brand M, Verdouw P (1983) The hemodynamic effect of intravenous flecainide acetate in patients with coronary artery disease. Br J Clin Pharmacol 16:51–59

    PubMed  CAS  Google Scholar 

  • Shen EN, Sung RJ, Morady F (1984) Electrophysiologic and hemodynamic effects of intravenous propafenone in patients with recurrent ventricular tachycardia. J Am Coll Cardiol 3:1291–1302

    Article  PubMed  CAS  Google Scholar 

  • Vanhaleweyk G, Serruys PW, Hugenholz PG (1984) Hemodynamic effects of encainide, flecainide, lorcainide and tocainide. Eur Heart J [Suppl B] 5:67–74

    PubMed  Google Scholar 

  • Wester HA, Mouselimis N (1982) Einfluß von Antiarrhythmika auf die Myokardfunktion. Dtsch Med Wochenschr 107:1262–1271

    Article  PubMed  CAS  Google Scholar 

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Henze, E., Roth, J., Kohler, J. et al. Long term inotropic effects of flecainide and propafenone. Eur J Nucl Med 13, 568–571 (1988). https://doi.org/10.1007/BF02574769

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