Ward D E, Cheesman M, Dancy M
Int J Cardiol. 1986 Mar;10(3):251-62. doi: 10.1016/0167-5273(86)90007-0.
The effect of flecainide acetate, a class 1c antiarrhythmic agent, was examined in 15 patients with recurrent ventricular tachycardia. Intravenous flecainide was administered in a dose of 2 mg/kg at the time of intracardiac stimulation and recording studies. Oral flecainide was given to 10/15 patients and retesting was undertaken using an indwelling electrode. Intravenous flecainide terminated sustained stable tachycardia in 8/11 patients and prevented reinitiation of tachycardia in 5/10 patients. Oral therapy prevented induction of tachycardias in only 2/10 patients. Five patients had non-sustained tachycardia and three had slower sustained tachycardia. "New" non-clinical tachycardias could be induced in six patients after flecainide but five of these had had more than one type of induced tachycardia. Four of 10 patients remained free of tachycardias during follow-up. Withdrawal of oral treatment was necessary in three patients, one of whom had severe proarrhythmic effects. Two patients required additional antiarrhythmic therapy. Long-term suppression could not be predicted from the results of oral therapy, but testing after intravenous drug seemed to be a more useful prognostic indicator. In summary, intravenous flecainide is effective for slowing and termination of stable ventricular tachycardia. Oral therapy is also effective but caution should be exerted in patients with multimorphic tachycardias.
对15例复发性室性心动过速患者研究了1c类抗心律失常药物醋酸氟卡尼的疗效。在进行心内刺激和记录研究时，静脉注射醋酸氟卡尼，剂量为2mg/kg。15例患者中有10例接受口服氟卡尼治疗，并使用留置电极进行再次检测。静脉注射氟卡尼使11例患者中的8例持续性稳定心动过速终止，使10例患者中的5例心动过速不再复发。口服治疗仅使10例患者中的2例不再诱发心动过速。5例患者有非持续性心动过速，3例有较慢的持续性心动过速。6例患者在使用氟卡尼后可诱发“新的”非临床性心动过速，但其中5例曾有过一种以上类型的诱发心动过速。10例患者中有4例在随访期间未出现心动过速。3例患者需要停用口服治疗，其中1例有严重的促心律失常作用。2例患者需要额外的抗心律失常治疗。无法根据口服治疗结果预测长期抑制效果，但静脉用药后的检测似乎是更有用的预后指标。总之，静脉注射氟卡尼对减慢和终止稳定的室性心动过速有效。口服治疗也有效，但对多形性心动过速患者应谨慎使用。
