Effect of encainide and flecainide on chronic ectopic atrial tachycardia
Open accessAbstract
In the treatment of chronic ectopic atrial tachycardia, standard antiarrhythmic therapy has been shown to be ineffective in the majority of patients. The intravenous and oral effects of two class IC antiarrhythmic drugs, encainide and flecainide, in five patients with chronic ectopic atrial tachycardia were studied using exercise testing, 24 hour long-term electrocardiography and programmed electrical stimulation. All patients had been treated unsuccessfully with at least four antiarrhythmic drugs. In two patients tachycardia was persistent, and in three patients tachycardia occurred intermittently for more than 12 hours/day. Intravenous encainide and flecainide at doses ranging from 0.3 to 2.0 mg/kg and from 0.5 to 1.5 mg/kg body weight, respectively, terminated atrial ectopic tachycardia in all patients. Oral encainide, 150 to 225 mg/day, completely suppressed ectopic atrial activity in four patients during a mean follow-up period of 8 +/- 3 months. In the remaining patient encainide markedly reduced the number of episodes of tachycardia. In three patients encainide had to be withdrawn because of intolerable side effects. These patients were well controlled with oral flecainide, 200 to 300 mg/day, without side effects. On the basis of these results, the efficacy of encainide and flecainide in the treatment of chronic ectopic atrial tachycardia appears to be not drug-specific but rather a general class IC property.
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Class Ia, Ic, and III drugs may work by prolonging the action potential or suppressing automaticity.
“Class Ia, Ic, and III drugs may work as well, by prolonging the action potential or suppressing automaticity.107,108,110”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [108]
Class Ia, Ic, and III drugs may be effective for chronic AT if first-line therapy failed, but Ia and Ic agents should ideally be combined with AV node blocking agents.
“Class Ia, Ic, and III drugs may be effective if first-line therapy has failed, but Ia and Ic agents should be ideally combined associated with AV node blocking agents.107 -109,115,116”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [108]
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- Authors
- Kunze, K.-P., Kuck, K.-H., Schlüter, M., & Bleifeld, W.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- ORCID
- Schlüter, Michael
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 1986-05
- Volume
- 7
- Issue
- 5
- Pages
- 1121-1126
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2016482152
- Cited by
- 87
- References
- 15
- Citations by year
- 2025: 3 · 2022: 3 · 2019: 2 · 2018: 1 · 2016: 4 · 2015: 6 · 2013: 1
- FWCI
- 8.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Keywords
- encainide, flecainide, class Ic antiarrhythmic drugs, drug efficacy, refractory tachycardia, intravenous administration, oral administration, programmed electrical stimulation
- MeSH terms
- Adult, Anilides, Chronic Disease, Electrophysiology, Female, Flecainide, Heart Atria, Humans, Male, Middle Aged, Piperidines, Tachycardia, Encainide
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