Efficacy of flecainide in patients with supraventricular arrhythmias and respiratory insufficiency.
OBJECTIVE
Evaluation of efficacy of intravenous flecainide to revert supraventricular arrhythmias to sinus rhythm in patients with respiratory insufficiency.


METHODS
Comparative randomized prospective trial.


METHODS
ICU in a University Hospital.


METHODS
30 patients with acute respiratory insufficiency or acute exacerbation of chronic respiratory insufficiency and supraventricular arrhythmias. Intravenous flecainide was administered to 15 patients (Group A) (2 mg/kg for 10 min and continuous perfusion of 1.5 mg/kg for 1 h). Intravenous verapamil was administered to 15 patients (Group B) (0.15 mg/kg for 5 min and continuous perfusion of 0.005 mg/kg/min for 1 h).


RESULTS
The categories of patients' arrhythmias were: Group A-atrial fibrillation (AF) in 5 cases, atrial flutter (AFl) in 2, multifocal atrial tachycardia (MAT) in 4 and other supraventricular tachycardia (SVT) in 4. Group B-AF in 6 cases, AFL in 2, MAT in 2 and SVT in 5 cases. Flecainide reverted arrhythmias to sinus rhythm in 12 out of 15 cases (80%); of these 12, 11 reverted with the initial bolus. Verapamil reverted 5 out of 12 cases (33.3%, p < 0.01). No significant secondary adverse effects were detected.


CONCLUSIONS
Intravenous flecainide is an effective antiarrhythmic drug to treat acute supraventricular arrhythmias in patients with respiratory insufficiency.
Barranco
F
F
Department of Intensive Medicine, Valme Universitary Hospital, Sevilla, Spain.
Sanchez
M
M
Rodriguez
J
J
Guerrero
M
M
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000209:etiology; D016009:Chi-Square Distribution; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D005424:Flecainide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000150:complications / Q000188:drug therapy*; D014700:Verapamil / Q000008:administration & dosage
D014700:Verapamil; D005424:Flecainide