title: Efficacy of flecainide in patients with supraventricular arrhythmias and respiratory insufficiency.
abstract: 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.
authors.affiliation: Department of Intensive Medicine, Valme Universitary Hospital, Sevilla, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Barranco
authors.forename: M
authors.initials: M
authors.lastname: Sanchez
authors.forename: J
authors.initials: J
authors.lastname: Rodriguez
authors.forename: M
authors.initials: M
authors.lastname: Guerrero
mesh_terms: 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
chemical_list: D014700:Verapamil; D005424:Flecainide