Flecainide.
Flecainide is a Class IC antiarrhythmic agent whose primary electrophysiologic effect is a slowing of conduction in a wide range of cardiac tissues. It is well absorbed and effective in suppressing isolated premature ventricular contractions (PVCs) or nonsustained ventricular arrhythmia but has only a modest efficacy when electrophysiologic testing is used as an endpoint. Its adverse effect on mortality in the CAST trial suggested a propensity to proarrhythmia--a phenomenon to which the Class IC agents appear particularly prone. Despite the applicability of the CAST study only to patients with a prior myocardial infarction, there has been a shift away from flecainide in ventricular arrhythmia, but the low noncardiac side effect profile of the agent allows for its continued use in a wide variety of supraventricular arrhythmias.
Falk
R H
RH
Section of Cardiology, Boston University School of Medicine, Massachusetts.
Fogel
R I
RI
D001281:Atrial Fibrillation / Q000188:drug therapy; D004562:Electrocardiography / Q000187:drug effects; D005424:Flecainide / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006321:Heart / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D017180:Tachycardia, Ventricular / Q000188:drug therapy
D005424:Flecainide