Nathan A W, Hellestrand K J, Bexton R S, Spurrell R A, Camm A J
Drugs. 1985;29 Suppl 4:45-53. doi: 10.2165/00003495-198500294-00010.
Flecainide acetate, a new potent class I antiarrhythmic agent, was administered to 152 patients (orally to 46, intravenously to 106) over a period of 22 months. Seven patients developed proarrhythmic effects. The only conduction abnormalities induced were PR interval prolongation and QRS complex widening, and no patient developed significant sinus bradyarrhythmias; patients with known serious abnormalities of impulse generation or conduction were excluded from this study. Five patients, of whom only 3 had pre-existing ventricular arrhythmias, developed ventricular tachycardia or ventricular fibrillation. QT and QTc interval prolongation was observed, but was due to QRS complex widening rather than an increase in the JT interval. A patient with Wolff-Parkinson-White syndrome had an inducible orthodromic atrioventricular tachycardia before flecainide administration, but only an antidromic tachycardia was induced after taking the drug. In 1 patient, flecainide administration resulted in an increase of atrial flutter cycle length, which resulted in the development of 1:1 atrioventricular conduction rate, and, overall, a faster ventricular rate. Two patients who developed ventricular arrhythmias were taking other antiarrhythmic agents, and in this series proarrhythmic effects occurred with both normal and high flecainide concentrations. Other published series are also summarised.
醋酸氟卡尼是一种新型强效I类抗心律失常药物，在22个月的时间里，对152例患者进行了给药治疗（46例口服，106例静脉注射）。7例患者出现了促心律失常效应。仅诱发了PR间期延长和QRS波群增宽等传导异常，无患者出现显著的窦性心动过缓；已知有严重冲动形成或传导异常的患者被排除在本研究之外。5例患者出现室性心动过速或心室颤动，其中只有3例既往有室性心律失常。观察到QT和QTc间期延长，但这是由于QRS波群增宽而非JT间期延长所致。1例预激综合征患者在服用氟卡尼前可诱发顺向型房室性心动过速，但服药后仅诱发了逆向型心动过速。1例患者服用氟卡尼后心房扑动周期长度增加，导致1:1房室传导率，总体心室率加快。2例出现室性心律失常的患者正在服用其他抗心律失常药物，在本系列中，正常和高浓度氟卡尼时均出现了促心律失常效应。其他已发表的系列研究也进行了总结。
