Dunselman P H, Kingma J H, van Wijk L M, Dijk A, Wesseling H, Lie K I
Drugs. 1985;29 Suppl 4:58-64. doi: 10.2165/00003495-198500294-00012.
The objective of this study was to evaluate the haemodynamic and antiarrhythmic effects of flecainide acetate in patients with heart failure. Flecainide acetate, a class Ic antiarrhythmic agent, was given intravenously to 9 patients with congestive heart failure and frequent ventricular arrhythmias with nonsustained ventricular tachycardia. The drug (2 mg/kg) was infused slowly over 60 minutes. The maximum plasma level achieved was 218 (range 142-350) ng/ml. Six of the 9 patients experienced a 90% suppression of their arrhythmias for an average of 6.5 (range 2-15) hours. Pre-ejection period control (PEPc, 148.8 +/- 3.6 msec) increased to 157 msec and pre-ejection period/ejection time (PEP/ET) [control 0.449 +/- 0.027] to 0.516 (p less than 0.005), while the ejection time index (ETI) did not change. Cardiac index (control 2.4 +/- 0.36 L/min/m2) decreased by 11% (p less than 0.02), and pulmonary wedge pressure (control 13.4 +/- 2.4mm Hg) increased by 23% (p less than 0.05). Stroke work index, arterial pressure and vascular resistance did not change significantly. The parameters returned to control values on completion of the infusion. Flecainide acetate can be safely administered at the usual dose of 2 mg/kg to patients with congestive heart failure, provided that the infusion time is doubled. Antiarrhythmic efficacy under these conditions is good even at lower plasma concentrations.
本研究的目的是评估醋酸氟卡尼对心力衰竭患者的血流动力学和抗心律失常作用。醋酸氟卡尼是一种Ic类抗心律失常药物，静脉注射给9例充血性心力衰竭且频发室性心律失常伴非持续性室性心动过速的患者。将药物（2mg/kg）在60分钟内缓慢输注。达到的最大血浆水平为218（范围142 - 350）ng/ml。9例患者中有6例心律失常得到90%的抑制，平均持续6.5（范围2 - 15）小时。射血前期控制值（PEPc，148.8±3.6毫秒）增至157毫秒，射血前期/射血时间（PEP/ET）[对照值0.449±0.027]增至0.516（p＜0.005），而射血时间指数（ETI）未改变。心脏指数（对照值2.4±0.36L/min/m²）下降11%（p＜0.02），肺楔压（对照值13.4±2.4mmHg）升高23%（p＜0.05）。每搏功指数、动脉压和血管阻力无显著变化。输注结束时参数恢复到对照值。对于充血性心力衰竭患者，只要输注时间加倍，醋酸氟卡尼可以以2mg/kg的常用剂量安全给药。在这些条件下，即使血浆浓度较低，抗心律失常疗效也良好。
