Prevention of arrhythmias by flecainide after noncardiac thoracic surgery.
Cardiac arrhythmias are a frequent complication after thoracic operations. The prophylactic value of flecainide administered as a constant-rate, intravenous infusion (0.15 mg/kg/h) after a loading dose (2 mg/kg) was tested in a randomized, placebo-controlled study in 30 patients using Holter monitoring during the first 72 hours after operation. A high incidence of atrial and complex ventricular arrhythmias was observed in the placebo-treated group, with a clear predominance in patients undergoing left thoracotomy. Antiarrhythmic drugs had to be added in 6 patients in the placebo-treated group (n = 16), but in none in the flecainide-treated group (n = 14) (p less than 0.01). The preventive effect of flecainide was observed at serum concentrations in the middle of the therapeutic range (409 ng/mL) without side effects. It is concluded that flecainide administration effectively reduced or prevented cardiac arrhythmias after thoracic operations.
Borgeat
A
A
Department of Anesthesiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Biollaz
J
J
Bayer-Berger
M
M
Kappenberger
L
L
Chapuis
G
G
Chioléro
R
R
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D004562:Electrocardiography; D005424:Flecainide / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011897:Random Allocation; D013903:Thoracic Surgery / Q000009:adverse effects*
D005424:Flecainide