Flecainide for supraventricular and ventricular arrhythmias in children and young adults

Zeigler, Vicki L.; Gillette, Paul C.; Ross, Bertrand A.; Ewing, Lesley L.

doi:10.1016/0002-9149(88)91232-5

Cited by 23 publications

(4 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In case series dating back to the 1980s, treatment efficacy of flecainide ranged between 50% an 85% 14,24–29 . These results are in line with a questionnaire based report of 369 patients on flecainide for SA in 36 centers from 1992 (70% 30 ), recently published data from two tertiary pediatric cardiology centers (78% in 175 patients 16 ) and the results presented here.…”

Section: Discussionsupporting

confidence: 89%

“…In case series dating back to the 1980s, treatment efficacy of flecainide ranged between 50% an 85%. 14,[24][25][26][27][28][29] These results are in line with a questionnaire based report of 369 patients on flecainide for SA in 36 centers from 1992 (70% 30 ), recently published data from two tertiary pediatric cardiology centers (78% in 175 patients 16 ) and the results presented here. Since we looked only at in-hospital arrhythmia control and did not include follow-up, our efficacy rate is slightly higher compared to the above mentioned reports (arrhythmia free discharge on mono-and combination therapy combined 91%).…”

Section: Comparison To Current Literature Discussing Flecainide Use I...supporting

confidence: 92%

“…Reports of discontinuation of flecainide due to adverse events in children range from 0% to 29% 14,16,24–30 irrespective of the presence of CHD. While, on average, QRS‐duration did not change significantly in our cohort, flecainide dosing was reduced or withdrawn during the loading phase due to significant QRS prolongation in 7 patients (9%).…”

Section: Discussionmentioning

confidence: 99%

“…31 While flecainide was mostly used later in the regimen at our institution, oftentimes after other therapy failures, flecainide is the most commonly used drug for prevention of recurrent SA in children in many European electrophysiological centers. 32 Reports of discontinuation of flecainide due to adverse events in children range from 0% to 29% 14,16,[24][25][26][27][28][29][30] irrespective of the presence of CHD. While, on average, QRS-duration did not change significantly in our cohort, flecainide dosing was reduced or withdrawn during the loading phase due to significant QRS prolongation in 7 patients (9%).…”

Section: Comparison To Current Literature Discussing Flecainide Use In Childrenmentioning

confidence: 99%

See 3 more Smart Citations

“Second line medications” for supraventricular arrhythmias in children: In‐hospital efficacy and adverse events during treatment initiation of sotalol and flecainide

Kahr

Moffett

Miyake

et al. 2021

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Introduction: Sotalol and flecainide are used as second line agents in children for the treatment of supraventricular arrhythmias (SA) refractory to anti-beta adrenergic antiarrhythmics or digoxin. Efficacy and adverse events in this cohort have not been well described. Here, we report our institutional experience of second line treatment initiation for SA in children. Methods and Results: Utilizing an institutional database, 247 patients initiated on sotalol and 81 patients initiated on flecainide were identified. Congenital heart disease (CHD) was present in 40% of patients. Arrhythmia-free discharge on single or dual agent therapy (in combination with other antiarrhythmics) was 87% for sotalol and 91% for flecainide. Neither age, sex, dosing, presence of CHD nor arrhythmia subtype were associated with alterations in in-hospital efficacy. Compared to baseline, QTc intervals in sotalol patients (436 [416-452 ms] vs. 415 [400-431 ms], p < .01) and QRS intervals in flecainide patients (75 [68-88 ms] vs. 62 [56-71 ms], p < .01) were prolonged. Dose reduction or discontinuation due to QRS prolongation occurred in 9% of patients on flecainide. QTc prolongation resulting in dose reduction/discontinuation of sotalol was encountered in 9 patients (4%) and death with documented torsade de pointes in 2 patients (1%), with 9 of 11 patients having underlying CHD. Conclusion:In children requiring second line agents for treatment of SA, both sotalol and flecainide appear to be highly efficacious. Although predominantly safe in otherwise healthy patients, electrocardiogram changes can occur and children with underlying cardiac disease may have an increased risk of adverse events and rhythm-related side effects during initiation.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Comparison To Current Literature Discussing Flecainide Use I...supporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Comparison To Current Literature Discussing Flecainide Use In Childrenmentioning

confidence: 99%

See 2 more Smart Citations

“Second line medications” for supraventricular arrhythmias in children: In‐hospital efficacy and adverse events during treatment initiation of sotalol and flecainide

Kahr

Moffett

Miyake

et al. 2021

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

A high performance liquid chromatographic method for the quantitation of flecainide in plasma

Broly

Marecaux

Houdret

et al. 1991

Biomedical Chromatography

View full text Add to dashboard Cite

A routine high performance liquid chromatographic method for the rapid determination of flecaïnide (Flecaine), using a novel internal standard, N-methylflecaïnide, has been developed. After deproteinization of spiked samples, flecaïnide was totally recovered at neutral pH. Flecaïnide and the internal standard were separated on a reversed phase XL 3 microns ODS column using 10 mM phosphate buffer, pH 3.0: acetonitrile (70:30) as mobile phase, in less than 10 min. With spectrofluorometric detection, the limit of quantitation for flecaïnide was 10 ng/mL. Intra- and inter-assay precision variations were 0.24% and 1.4%.

show abstract

High-Performance Liquid Chromatographic Determination of the Enantiomers of Flecainide in Human Plasma and Urine

Alessi‐Severini

Jamali

Pasutto

et al. 1990

Journal of Pharmaceutical Sciences

View full text Add to dashboard Cite

Flecainide for supraventricular and ventricular arrhythmias in children and young adults

Cited by 23 publications

References 7 publications

“Second line medications” for supraventricular arrhythmias in children: In‐hospital efficacy and adverse events during treatment initiation of sotalol and flecainide

“Second line medications” for supraventricular arrhythmias in children: In‐hospital efficacy and adverse events during treatment initiation of sotalol and flecainide

A high performance liquid chromatographic method for the quantitation of flecainide in plasma

High-Performance Liquid Chromatographic Determination of the Enantiomers of Flecainide in Human Plasma and Urine

Contact Info

Product

Resources

About