Flecainide
Flecainide is a Vaughan Williams class 1c antiarrhythmic. It slows conduction of the action potential by acting as a potent sodium channel blocker. This may be reflected by widening of the QRS complex and prolongation of the PR interval
The Cardiac Arrhythmia Suppression Trial (CAST, 1989) investigated the use of agents to treat asymptomatic or mildly symptomatic premature ventricular complexes (PVCs) post myocardial infarction. The hypothesis was that this would reduce deaths from ventricular arrhythmias. Flecainide was actually shown to increase mortality post myocardial infarction and is therefore contraindicated in this situation
Indications
Adverse effects
The Cardiac Arrhythmia Suppression Trial (CAST, 1989) investigated the use of agents to treat asymptomatic or mildly symptomatic premature ventricular complexes (PVCs) post myocardial infarction. The hypothesis was that this would reduce deaths from ventricular arrhythmias. Flecainide was actually shown to increase mortality post myocardial infarction and is therefore contraindicated in this situation
Indications
- atrial fibrillation
- SVT associated with accessory pathway e.g. Wolf-Parkinson-White syndrome
Adverse effects
- negatively inotropic
- bradycardia
- proarrhythmic
- oral paraesthesia
- visual disturbances