The Antiarrhythmic Mechanisms of Flecainide in Catecholaminergic Polymorphic Ventricular Tachycardia

Li, Yukun; Peng, Xiaodong; Lin, Rong; Wang, Xuesi; Liu, Xinmeng; Bai, Rong; Ma, Changsheng; Tang, Ruiyi; Ruan, Yijun; Liu, Nian

doi:10.3389/fphys.2022.850117

Cited by 5 publications

(4 citation statements)

References 54 publications

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“…Среди препаратов, применяемых в дополнение к базовой терапии бета-адреноблокаторами, наиболее часто в литературе упоминается флекаинид -антиаритмический препарат IС класса [5]. Этот препарат купирует не только суправентрикулярные эктопические аритмии, но и желудочковые нарушения ритма [19]. Механизмы подавления флекаинидом триггерной эктопической активности остаются предметом дискуссий [20,21].…”

Section: другая антиаритмическая терапияunclassified

Management of Catecholaminergic Polymorphic Ventricular Tachycardia

Kulbachinskaya,

Bereznitskaya

2024

Vopr. sovr. pediatr.

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Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a primary electrical heart disease characterized by the development of polymorphic (including bidirectional) ventricular tachycardia in response to adrenergic stimulation. The leading clinical sign of CPVT is syncope provoked by physical or emotional stress, or adrenergic drugs administration. This disease is characterized by high mortality if not treated. The main treatment approach for CPVT is drug therapy with beta-blockers. Recently, however, there are more and more works stating that beta-blockers have lack of efficacy. Combination therapy with the antiarrhythmic drug of the IC class is one of the approaches before implementing the interventional treatment methods in several patients. Interventional methods include cardioverter defibrillator implantation and left side sympathectomy. This paper presents the modern view on the efficacy, safety, and indications for every management method for patients with CPVT.

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Section: другая антиаритмическая терапияunclassified

Management of Catecholaminergic Polymorphic Ventricular Tachycardia

Kulbachinskaya,

Bereznitskaya

2024

Vopr. sovr. pediatr.

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“…The other class IC AADs (Flecainide and Propafenone) are mainly used for supraventricular arrythmias. An exception is their administration in catecholaminergic polymorphic ventricular tachycardia, because of their negative effect on the RYR2 calcium channel and sodium currents [ 67 ].…”

Section: Medical Therapymentioning

confidence: 99%

Emergency Management of Electrical Storm: A Practical Overview

et al. 2023

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Electrical storm is a medical emergency characterized by ventricular arrythmia recurrence that can lead to hemodynamic instability. The incidence of this clinical condition is rising, mainly in implantable cardioverter defibrillator patients, and its prognosis is often poor. Early acknowledgment, management and treatment have a key role in reducing mortality in the acute phase and improving the quality of life of these patients. In an emergency setting, several measures can be employed. Anti-arrhythmic drugs, based on the underlying disease, are often the first step to control the arrhythmic burden; besides that, new therapeutic strategies have been developed with high efficacy, such as deep sedation, early catheter ablation, neuraxial modulation and mechanical hemodynamic support. The aim of this review is to provide practical indications for the management of electrical storm in acute settings.

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“…[ 57 ] Its therapeutic mechanism, however, is still unclear, and could be attributed to several mechanisms involving sodium channels and RyR2 blockade. [ 61 ] Moreover, a recent study has also suggested that flecainide’s interaction with certain genetic variants could lead to arrhythmogenesis, highlighting the necessity of further research on its pharmacological mechanism. [ 62 ]…”

Section: Advances In Catecholaminergic Polymorphic Ventricular Tachyc...mentioning

confidence: 99%

Precision medicine in catecholaminergic polymorphic ventricular tachycardia: Recent advances toward personalized care

Siu,

Tandanu,

et al. 2023

Annals of Pediatric Cardiology

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Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited cardiac ion channelopathy where the initial disease presentation is during childhood or adolescent stages, leading to increased risks of sudden cardiac death. Despite advances in medical science and technology, several gaps remain in the understanding of the molecular mechanisms, risk prediction, and therapeutic management of patients with CPVT. Recent studies have identified and validated seven sets of genes responsible for various CPVT phenotypes, including RyR2, CASQ-2, TRDN, CALM1, 2, and 3, and TECRL, providing novel insights into the molecular mechanisms. However, more data on atypical CPVT genotypes are required to investigate the underlying mechanisms further. The complexities of the underlying genetics contribute to challenges in risk stratification as well as the uncertainty surrounding nongenetic modifiers. Therapeutically, although medical management involving beta-blockers and flecainide, or insertion of an implantable cardioverter defibrillator remains the mainstay of treatment, animal and stem cell studies on gene therapy for CPVT have shown promising results. However, its clinical applicability remains unclear. Current gene therapy studies have primarily focused on the RyR2 and CASQ-2 variants, which constitute 75% of all CPVT cases. Alternative approaches that target a broader population, such as CaMKII inhibition, could be more feasible for clinical implementation. Together, this review provides an update on recent research on CPVT, highlighting the need for further investigation of the molecular mechanisms, risk stratification, and therapeutic management of this potentially lethal condition.

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The Antiarrhythmic Mechanisms of Flecainide in Catecholaminergic Polymorphic Ventricular Tachycardia

Cited by 5 publications

References 54 publications

Management of Catecholaminergic Polymorphic Ventricular Tachycardia

Management of Catecholaminergic Polymorphic Ventricular Tachycardia

Emergency Management of Electrical Storm: A Practical Overview

Precision medicine in catecholaminergic polymorphic ventricular tachycardia: Recent advances toward personalized care

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