This report summarizes efficacy and safety data on the use of
flecainide acetate for supraventricular arrhythmias. For this purpose, 60 original articles were identified by a literature search representing data from 1,835 treatment courses. In 18 trials,
flecainide was administered intravenously; in 19, orally; and in 23, both forms of
therapy were applied. There were 5 placebo-controlled and 12 comparative studies, whereas data from uncontrolled studies were represented in 43 articles. Short-term
flecainide administration terminated
atrial fibrillation in 65% of attempts and terminated
atrial flutter in 28%. The
drug was effective during long-term
therapy for
atrial fibrillation in 49% of patients, with similar efficacy rates in 11 comparative trials and in 16 uncontrolled studies. In randomized, placebo-controlled studies in patients with
paroxysmal atrial fibrillation,
flecainide was shown to reduce significantly the number of attacks, to prolong the time between attacks, and to improve quality of life. In patients with atrioventricular (AV)
reciprocating tachycardias, acute
drug administration was successful in 72%; 83% of patients with AV nodal reentrant
tachycardias and 74% exhibiting arrhythmias associated with the
Wolff-Parkinson-White syndrome responded acutely. During long-term
therapy, efficacy rates were 70%, 78%, and 69%, respectively.
Ectopic atrial tachycardia responded in 86% and 95% of patients treated with
flecainide acutely or chronically. Data concerning
drug-related side effects were available for 1,794 of 1,835 treatment courses (98%). Overall, 352 of 1,794 patients (20%) reported at least one non-cardiac or cardiac adverse experience.(ABSTRACT TRUNCATED AT 250 WORDS)