Flecainide Reduces Ventricular Arrhythmias in Patients With Genotype RyR2-positive Catecholaminergic Polymorphic Ventricular Tachycardia.

Autor: Wangüemert Pérez F; Departamento de Cardiología, Cardiavant Centro Médico Cardiológico, Las Palmas de Gran Canaria, Las Palmas, Spain. Electronic address: fwanguemert@mac.com., Hernández Afonso JS; Departamento de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain., Groba Marco MDV; Departamento de Cardiología, Cardiavant Centro Médico Cardiológico, Las Palmas de Gran Canaria, Las Palmas, Spain; Departamento de Cardiología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain., Caballero Dorta E; Departamento de Cardiología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain., Álvarez Acosta L; Departamento de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain., Campuzano Larrea O; Departamento de Genética, Cardiovascular Genetics Center, Gencardio, Institut d'Investigacions Biomèdiques de Girona (IDIBGI), Girona, Spain., Pérez G; Departamento de Genética, Cardiovascular Genetics Center, Gencardio, Institut d'Investigacions Biomèdiques de Girona (IDIBGI), Girona, Spain., Brugada Terradellas J; Departamento de Cardiología, Institut Clínic del Tòrax, Hospital Universitario Clínic de Barcelona, Universidad de Barcelona, Barcelona, Spain., Brugada Terradellas R; Departamento de Genética, Cardiovascular Genetics Center, Gencardio, Institut d'Investigacions Biomèdiques de Girona (IDIBGI), Girona, Spain.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de cardiologia (English ed.) [Rev Esp Cardiol (Engl Ed)] 2018 Mar; Vol. 71 (3), pp. 185-191. Date of Electronic Publication: 2017 Aug 05.
DOI: 10.1016/j.rec.2017.04.032
Abstrakt: Introduction and Objectives: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited disease characterized by polymorphic or bidirectional ventricular arrhythmias (VA) triggered by physical or emotional stress in young people with a structurally normal heart. Beta-blockers are the cornerstone of treatment, while flecainide has recently been incorporated into the therapeutic arsenal. The aim of this study was to report our experience with this drug.
Methods: The cohort included 174 genotype-positive CPVT-patients from 7 families. We collected data from patients who were receiving flecainide and analyzed the indications, adverse effects and dosage, clinical events, VA and arrhythmic window during exercise testing, and implantable cardioverter-defibrillator (ICD) shocks during follow-up.
Results: Eighteen patients (10.4%) received flecainide; 17 patients in combination with beta-blockers, and 1 patient as monotherapy due to beta-blocker intolerance. None of the patients presented side effects. In 13 patients (72.2%) the indication was the persistence of exercise-induced VA and in 5 patients (27.7%) persistent ICD-shocks, despite on beta-blockers. After flecainide initiation, the exercise-induced VA quantitative score was reduced by more than 50% in 66.7% of the members of family 1 (32.76 ± 84.06 vs 74.38 ± 153.86; P = .018). The arrhythmic window was reduced (5.8 ± 11.9 bpm vs 19.69 ± 21.27 bpm; P = .007), and 4 of 5 patients with appropriate ICD shocks experienced no further shocks in the follow-up.
Conclusions: In CPVT-patients flecainide reduces clinical events, exercise-induced VA, the arrhythmic window, and ICD shocks, with good tolerance.
(Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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