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Flecainide in clinical practice
Affiliations- Medical University of Silesia in Katowice, Poland
- 1st Department of Cardiology, Medical University of Warsaw, Poland
- 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Poland
- Department of Human Nutrition, School of Public Health in Bytom Silesian Medical University in Katowice, Silesian Center of Heart Disease in Zabrze, Poland
- Department of Cardiology DMS in Zabrze Medical University of Silesia, Katowice, Poland
- 1st Department of Cardiology, Medical University of Gdansk, Poland
- Department of Cardiology and Internal Disease, Medical University of Gdansk, Poland
- 1st Arrhythmia Department, National Institute of Cardiology, Warsaw, Poland
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Abstract
Flecainide, similar to encainide and propafenone, is IC class antiarrhythmic, inhibiting Nav1.5 sodium channels in heart muscle cells and modulates cardiac conduction. Despite its over 40-year presence in clinical practice, strong evidence and well-known safety profile, flecainide distribution in Europe has not always been equal. In Poland, the drug has been available in pharmacies only since October this year, and previously it had to be imported on request. Flecainide can be used successfully in both the acute and chronic treatment of cardiac arrhythmias. The main indication for flecainide is the treatment of paroxysmal supraventricular tachycardias, including atrial fibrillation, atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia and ventricular arrhythmias in patients without structural heart disease. Beyond that, it may be used in some supraventricular tachycardia in children and for sustained fetal tachycardia. Many studies indicate its efficacy comparable to or better than previously used drugs such as propafenone and amiodarone, depending on the indication. This review aims to highlight the most important clinical uses of flecainide in the light of the latest scientific evidence and to provide an overview of the practical aspects of treatment, including indications, off-label use, contraindications, areas of use, monitoring of treatment and most common complications, taking into account special populations: children and pregnant women
Abstract
Flecainide, similar to encainide and propafenone, is IC class antiarrhythmic, inhibiting Nav1.5 sodium channels in heart muscle cells and modulates cardiac conduction. Despite its over 40-year presence in clinical practice, strong evidence and well-known safety profile, flecainide distribution in Europe has not always been equal. In Poland, the drug has been available in pharmacies only since October this year, and previously it had to be imported on request. Flecainide can be used successfully in both the acute and chronic treatment of cardiac arrhythmias. The main indication for flecainide is the treatment of paroxysmal supraventricular tachycardias, including atrial fibrillation, atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia and ventricular arrhythmias in patients without structural heart disease. Beyond that, it may be used in some supraventricular tachycardia in children and for sustained fetal tachycardia. Many studies indicate its efficacy comparable to or better than previously used drugs such as propafenone and amiodarone, depending on the indication. This review aims to highlight the most important clinical uses of flecainide in the light of the latest scientific evidence and to provide an overview of the practical aspects of treatment, including indications, off-label use, contraindications, areas of use, monitoring of treatment and most common complications, taking into account special populations: children and pregnant women
Keywords
flecainide, atrial fibrillation, cardioversion, supraventricular arrhythmias, ventricular arrhythmias
About this articleTitle
Flecainide in clinical practice
Journal
Issue
Article type
Review Article
Published online
2023-03-10
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313
Article views/downloads
169
DOI
10.5603/CJ.a2023.0018
Pubmed
Keywords
flecainide
atrial fibrillation
cardioversion
supraventricular arrhythmias
ventricular arrhythmias
Authors
Mikołaj Basza
Cezary Maciejewski
Wojciech Bojanowicz
Paweł Balsam
Marcin Grabowski
Przemysław Mitkowski
Maciej Kempa
Oskar Kowalski
Zbigniew Kalarus
Miłosz Jaguszewski
Andrzej Lubiński
Ludmiła Daniłowicz-Szymanowicz
Łukasz Szumowski
Maciej Sterliński
Łukasz Kołtowski
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