Suppression by flecainide of premature ventricular contractions refractory to catheter ablation and other antiarrhythmic drugs: a case report
https://doi.org/10.35336/VA-1458
EDN: ROKDFW
Abstract
We describe suppression of frequent premature ventricular contractions from the papillary muscle by flecainide in a patient with a history of reversible cardiomyopathy associated with arrhythmia and ineffective antiarrhythmic therapy with other IC and III class drugs, as well as refractory to repeated catheter ablation.
About the Authors
Yu. G. ShchukinaRussian Federation
Yulia G. Shchukina.
Saint Petersburg, 2 Akkuratova str.
E. I. Condori Leandro
Russian Federation
Saint Petersburg, 2 Akkuratova str.
D. S. Lebedev
Russian Federation
Saint Petersburg, 2 Akkuratova str.
E. N. Mikhailov
Russian Federation
Saint Petersburg, 2 Akkuratova str.
References
1. Issa ZF, Miller JM, Zipes DP. Clinical Arrhythmology and Electrophysiology. 2022. 1376 p.
2. Kuzhel DA, Savchenko EA. Premature ventricular complexes: new possibilities of diagnostics and management. Eurasian heart journal. 2024;(1): 116-125. (In Russ.) https://doi.org/10.38109/2225-1685-2024-1-116-125.
3. Olesin AI, Konstantinova IV, Zueva YuS, Sokolova MD. Ventricular extrasystoles in patients without cardiac structural changes: mechanisms of development, arrhythmogenic cardiomyopathy predictors, pharmacological and nonpharmacological treatment strategies. International Heart and Vascular Disease Journal. 2020;8(26): 28-39. (In Russ.)
4. Latchamsetty R, Yokokawa M, Morady F, et al. Multicenter Outcomes for Catheter Ablation of Idiopathic Premature Ventricular Complexes, JACC: Clinical Electrophysiology. 2015, Volume 1, Issue 3, Pages 116-123, ISSN 2405-500X. https://doi.org/10.1016/j.jacep.2015.04.005.
5. Gulletta S, Gasperetti A, Schiavone M, et al. Long-Term Follow-Up of Catheter Ablation for Premature Ventricular Complexes in the Modern Era: The Importance of Localization and Substrate. Journal of Clinical Medicine. 2022. 11(21): 6583. https://doi.org/10.3390/jcm11216583.
6. Vyrva AA, Shtegman OA, Ivanitskiy EA, et al. Results of catheter ablation in patients with idiopathic premature ventricular contractions depending on the use of fluoroscopy. Russian Journal of Cardiology. 2020;25(7):3719. (In Russ.). https://doi.org/10.15829/1560-4071-2020-3719.
7. Atici A, Sahin I, Doğan Ö, et al. Can the efficacy of a medical treatment be predicted based on the type of idiopathic premature ventricular contraction? Journal of Electrocardiology. 2024;86: 153782 https://doi.org/10.1016/j.jelectrocard.2024.153782.
8. Tsaregorodtsev DA, Sokolov AV, Vasyukov SS, et al. Treatment for ventricular arrhythmias in the absence of structural heart disease: from guidelines to clinical practice. Therapeutic Archive. 2017;89(12): 157-164. (In Russ.) https://doi.org/10.17116/terarkh20178912157-164.
9. Yamada T, Doppalapudi H, McElderry Hat, et al. Electrocardiographic and electrophysiological characteristics in idiopathic ventricular arrhythmias originating from the papillary muscles in the left ventricle: relevance for catheter ablation. Circ Arrhythm Electrophysiol. 2010;3(4): 324-31. https://doi.org/10.1161/CIRCEP.109.922310.
10. Condori Leandro H.I., Lebedev D.S., Mikhaylov E.N. Therapeutic potential of flecainide for cardiac arrhythmias: a short review of studies and clinical recommendations. Journal of Arrhythmology. 2024;31(3): е1-е7. (In Russ.) https://doi.org/10.35336/VA-1397.
11. Kojić D, Radunović A, Bukumirić Z, et al. Idiopathic premature ventricular complexes treatment: comparison of flecainide, propafenone, and sotalol. Clin Cardiol. 2023;46: 1220-1226. https://doi.org/10.1002/clc.24090.
12. Abitbol H, Califano JE, Abate C, Beilis P, et al.Use of flecainide acetate in the treatment of premature ventricular contractions. Am Heart J. 1983;105(2):227-30. https://doi.org/10.1016/0002-8703(83)90518-5.
13. Bertels RA, Kammeraad JAE, van Geloven N, Filippini LH, et al. ECTOPIC trial: The efficacy of flEcainide Compared To metOprolol in reducing Premature ventrIcular Contractions: A randomized open-label crossover study in pediatric patients. Heart Rhythm. 2024; 1547-5271(24)03090-X. https://doi.org/10.1016/j.hrthm.2024.07.111.
14. Lebedev DS, Mikhailov EN, Neminuschiy NM, et al. Ventricular arrhythmias. Ventricular tachycardias and sudden cardiac death. 2020 Clinical guidelines. Russian Journal of Cardiology. 2021;26(7): 4600 (In Russ.) https://doi.org/10.15829/1560-4071-2021-4600.
15. Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for the management of patients with ven tricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2022;43(40): 3997-4126. https://doi.org/10.1093/eurheartj/ehac262.
Review
For citations:
Shchukina Yu.G., Condori Leandro E.I., Lebedev D.S., Mikhailov E.N. Suppression by flecainide of premature ventricular contractions refractory to catheter ablation and other antiarrhythmic drugs: a case report. Journal of Arrhythmology. 2025;32(1):e1-e5. https://doi.org/10.35336/VA-1458. EDN: ROKDFW