EFFICACY OF FLECAINIDE IN PATIENTS WITH SUPRAVENTRICULAR ARRHYTHMIAS AND RESPIRATORY INSUFFICIENCY

Objective: Evaluation of efficacy of intravenous flecainide to revert supraventricular arrhythmias to sinus rhythm in patients with respirat ory insufficiency. Design: Comparative randomized prospective trial. S etting: ICU in a University Hospital. Patients: 30 patients with acute respiratory insufficiency or acute exscerbation of chronic respirator y insufficiency and supraventricular arrhythmias. Intravenous flecaini de was administered to 15 patients (Group A) (2 mg/kg for 10 min and c ontinuous perfusion of 1.5 mg/kg for 1 h). Intravenous verapamil was a dministered to 15 patients (Group B) (0.15 mg/kg for 5 min and continu ous perfusion of 0.005 mg/kg/min for 1 h). Measurements and results: T he categories of patients' arrhythmias were: Group A - atrial fibrilla tion (AF) in 5 cases, atrial flutter (AF1) in 2, multifocal atrial tac hycardia (MAT) in 4 and other supraventricular tachycardia (SVT) in 4. Group B - AF in 6 cases, AFL in 2, MAT in 2 and SVT in 5 cases. Fleca inide reverted arrhythmias to sinus rhythm in 12 out of 15 cases (80%) ; of these 12, 11 reverted with the initial bolus. Verapamil reverted 5 out of 12 cases (33.3%, p<0.01). No significant secondary adverse ef fects were detected. Conclusion: Intravenous flecainide is an effectiv e antiarrhythmic drug to treat acute supraventricular arrhythmias in p atients with respiratory insufficiency.