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Cited by 193Cardiac electrophysiology and arrhythmiasCardiac Arrhythmias and TreatmentsPharmacovigilance and Adverse Drug Reactions

The DOI matches its Crossref record; 37 of the 37 references it cites were found in a registry or an index.

Proarrhythmia, cardiac arrest and death in young patients receiving encainide and flecainide

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Fish, Frank A, Gillette, Paul C, Benson, D.Woodrow·1991·Journal of the American College of Cardiology
DOI 10.1016/0735-1097(91)90586-x
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Abstract

The potential for proarrhythmic responses to the class IC sodium channel-blocking drugs encainide and flecainide has not been well described in young patients. Therefore, data were retrospectively collected from 36 institutions regarding 579 young patients who were administered encainide or flecainide for treatment of supraventricular tachycardias (encainide 86 patients, flecainide 369 patients) or ventricular arrhythmias (encainide 21 patients, flecainide 103 patients) to assess the frequency of proarrhythmia, cardiac arrest and death during therapy (adverse events). The two drugs were similar in regard to efficacy (flecainide 71.4%, encainide 59.8%) and rate of proarrhythmic responses (flecainide 7.4%; encainide 7.5%). However, patients receiving encainide more frequently experienced cardiac arrest (encainide 7.5% vs. flecainide 2.3%, p less than 0.05) or died during treatment (encainide 7.5% vs. flecainide 2.1%, p less than 0.05). Detailed data were provided for 44 patients experiencing one or more adverse events. Patient age, previous drug trials, concomitant therapy and days of inpatient monitoring were similar for patients receiving encainide or flecainide. However, echocardiographic left ventricular shortening before treatment was lower among patients receiving encainide (0.23 +/- 0.09) than among those receiving flecainide (0.34 +/- 0.06, p less than 0.05). Plasma drug concentrations were rarely elevated. Cardiac arrest (12 patients) and deaths (13 patients) occurred predominantly among patients with underlying heart disease, particularly among patients receiving flecainide for supraventricular tachycardia (8.3% vs. 0.3%, p less than 0.001). Fifteen patients with an ostensibly normal heart and normal ventricular function experienced proarrhythmia during treatment for supraventricular tachycardia, but only 3 of the 15 had a cardiac arrest or died. The relatively high incidence of adverse events should be considered when contemplating treatment with encainide or flecainide, particularly among patients with underlying heart disease.

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Metadata

Authors
Fish, F. A., Gillette, P. C., & Benson, D. W.
Affiliations
  • Northwestern University (US)
  • Medical University of South Carolina (US)
Corresponding author
Fish, Frank A
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
1991-08
Volume
18
Issue
2
Pages
356-365
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/0735-1097(91)90586-x
OpenAlex
W2084942160
Cited by
193
References
37
Citations by year
2026: 3 · 2025: 2 · 2024: 2 · 2023: 6 · 2022: 3 · 2021: 9 · 2020: 4 · 2019: 6 · 2018: 4 · 2017: 14 · 2016: 3 · 2015: 8 · 2014: 13 · 2013: 8 · 2012: 7
FWCI
6.21
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
Keywords
encainide, flecainide, class Ic antiarrhythmic drugs, drug-induced arrhythmia, cardiac arrest, drug-induced death, young patients, supraventricular tachycardia, ventricular arrhythmias, underlying heart disease, left ventricular shortening, adverse drug reactions, sodium channel blockers, plasma drug concentration, inpatient monitoring, drug safety and efficacy
MeSH terms
Anilides, Anti-Arrhythmia Agents, Arrhythmias, Cardiac, Child, Death, Sudden, Flecainide, Heart Arrest, Humans, Retrospective Studies, Risk Factors, Tachycardia, Tachycardia, Supraventricular, Incidence, Encainide

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