vestarВестник аритмологииJournal of Arrhythmology1561-86412658-7327НАО «Инкарт»10.35336/VA-1448vestar-1530Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL ARTICLESSafety of out-of-hospital initiation of flecainide in patients with atrial and ventricular arrhythmias and structurally normal heartSafety of out-of-hospital initiation of flecainide in patients with atrial and ventricular arrhythmias and structurally normal hearthttps://orcid.org/0000-0002-7065-497XEl-DamatyAhmedEl-DamatyAhmed

Al kasr Al Aini, Old Cairo, Cairo governorate, 4240310 

Al kasr Al Aini, Old Cairo, Cairo governorate, 4240310 

Ahmed.damaty@kasralainy.edu.eghttps://orcid.org/0000-0001-7669-3569Kader IsmailEslam Talaat AbdelKader IsmailEslam Talaat Abdel

34M2+5X5, Qism Bani Sweif, Beni Suef, Beni Suef Governorate 

34M2+5X5, Qism Bani Sweif, Beni Suef, Beni Suef Governorate 

https://orcid.org/0009-0000-0743-1434Shabban KhalilAhmedShabban KhalilAhmed

Al kasr Al Aini, Old Cairo, Cairo governorate, 4240310 

Al kasr Al Aini, Old Cairo, Cairo governorate, 4240310 

https://orcid.org/0000-0001-8120-0917Shaban AliAhmedShaban AliAhmed

34M2+5X5, Qism Bani Sweif, Beni Suef, Beni Suef Governorate 

34M2+5X5, Qism Bani Sweif, Beni Suef, Beni Suef Governorate 

Cardiology department, Cairo UniversityЕгипетCardiology department, Cairo UniversityEgyptCardiology department, Beni-Suef UniversityЕгипетCardiology department, Beni-Suef UniversityEgypt2025130620253221217Copyright © El-Damaty A., Kader Ismail E., Shabban Khalil A., Shaban Ali A., 20252025El-Damaty A., Kader Ismail E., Shabban Khalil A., Shaban Ali A.El-Damaty A., Kader Ismail E., Shabban Khalil A., Shaban Ali A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestar.elpub.ru/jour/article/view/1530Aim

Aim. This study aimed at investigating the safety of out-of-hospital initiation of flecainide in patients presenting with atrial or ventricular arrhythmias and structurally normal heart.

Methods

Methods. Patients were followed 1 week, 1 month and 2 months after drug initiation either in person or through phone interviews and were asked to report symptoms suggestive of sustained arrhythmia, syncope, aborted sudden death and/or emergency room (ER) visits. QRS duration and QTc intervals were measured in a 12-lead ECG at each follow up. Patients were asked to fill out a treatment satisfaction questionnaire for medication (TSQM), four weeks after drug initiation.

Results

Results. The mean patient age was 48.5 ± 15.7 years, 36 patients (52%) were females. The most frequent presenting arrhythmia was premature ventricular contractions in 34 (45.3%) patients followed by paroxysmal atrial fibrillation in 22 (29.3%) patients. There was a significant increase in the mean QRS duration (89.9 ± 6.8 msec vs 91.1±7 msec, P <0.001) and the mean QTc interval (417.4 ±10.6 msec vs 418 ± 10.4 msec, P = 0.025) at 1 week compared to baseline. Only one patient (1.3%) had a clinically significant (more than 25%) increase in the QRS duration requiring drug discontinuation. There was no reported life-threatening ventricular arrhythmia, syncope, ER visits or aborted sudden cardiac death. There was 6.7% incidence of cardiac adverse events including conduction system abnormalities and atrial flutter, 4% of patients experienced non-resolving extracardiac manifestations. The overall drug discontinuation rate was 10.7%. The mean TSQM score for effectiveness domain was 70.4 ± 23.8 while the mean of the side effects domain was 94.3 ± 14.6, that of convenience domain was 65.2 ± 10.5 and that of global satisfaction was 72.8 ± 21.8.

Conclusion

Conclusion. Out-of-hospital initiation of flecainide is safe and thus feasible, there was no reported documented or suspected life-threatening ventricular arrhythmias. Cardiac and extracardiac adverse events requiring drug discontinuation was effectively detected through clinical and ECG outpatient follow up.

Aim

Aim. This study aimed at investigating the safety of out-of-hospital initiation of flecainide in patients presenting with atrial or ventricular arrhythmias and structurally normal heart.

Methods

Methods. Patients were followed 1 week, 1 month and 2 months after drug initiation either in person or through phone interviews and were asked to report symptoms suggestive of sustained arrhythmia, syncope, aborted sudden death and/or emergency room (ER) visits. QRS duration and QTc intervals were measured in a 12-lead ECG at each follow up. Patients were asked to fill out a treatment satisfaction questionnaire for medication (TSQM), four weeks after drug initiation.

Results

Results. The mean patient age was 48.5 ± 15.7 years, 36 patients (52%) were females. The most frequent presenting arrhythmia was premature ventricular contractions in 34 (45.3%) patients followed by paroxysmal atrial fibrillation in 22 (29.3%) patients. There was a significant increase in the mean QRS duration (89.9 ± 6.8 msec vs 91.1±7 msec, P <0.001) and the mean QTc interval (417.4 ±10.6 msec vs 418 ± 10.4 msec, P = 0.025) at 1 week compared to baseline. Only one patient (1.3%) had a clinically significant (more than 25%) increase in the QRS duration requiring drug discontinuation. There was no reported life-threatening ventricular arrhythmia, syncope, ER visits or aborted sudden cardiac death. There was 6.7% incidence of cardiac adverse events including conduction system abnormalities and atrial flutter, 4% of patients experienced non-resolving extracardiac manifestations. The overall drug discontinuation rate was 10.7%. The mean TSQM score for effectiveness domain was 70.4 ± 23.8 while the mean of the side effects domain was 94.3 ± 14.6, that of convenience domain was 65.2 ± 10.5 and that of global satisfaction was 72.8 ± 21.8.

Conclusion

Conclusion. Out-of-hospital initiation of flecainide is safe and thus feasible, there was no reported documented or suspected life-threatening ventricular arrhythmias. Cardiac and extracardiac adverse events requiring drug discontinuation was effectively detected through clinical and ECG outpatient follow up.

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The authors declare that there are no conflicts of interest present.