Arrhythmias & electrophysiology
Flecainide for the Treatment of Andersen-Tawil Syndrome
Main finding · Positive exercise treadmill test (any ventricular arrhythmia other than occasional single premature ventricular contractions)Result — go to the resultOdds ratio 0.13Authors' conclusion
These data demonstrate that flecainide treatment may be effective and well-tolerated in ATS1 patients. The occurrence of an arrhythmic storm in 1 patient underscores the potential for toxicity and mandates careful dose titration monitored by rest and exercise electrocardiogram for QRS widening.
Study context
- Population
- Patients with Andersen-Tawil syndrome type 1 (ATS1)ATS1 patients
- Participants
- 31 patients
- Exposure
- Flecainide treatment vs pretreatment
- Outcome
- Positive exercise treadmill test (any ventricular arrhythmia other than occasional single premature ventricular contractions)
Methodological detailsconsecutive ATS1 patients from 9 centers
- Consecutive ATS1 patients from 9 centers
Main finding
As reported in the abstract
Odds ratio
0.13
P = 0.035
Events by group
Pretreatment
16 of 18
events
Flecainide
5 of 18
events
Observational data: associations, not effects.
Further findings
Premature ventricular contraction burden · decreased with flecainide
decrease 84.8% (71.5%–100%) · P < 0.001
| Outcome | Flecainide | Pretreatment |
|---|---|---|
| Nonsustained ventricular tachycardia on exercise treadmill test | One events | 6 events |
Ventricular arrhythmia score (most severe arrhythmia on Holter monitoring)
- Improved in patients
- 66%
- Mean improvement
- 0.62 ± 1.6 U; P = 0.005
Becoming symptom-free (symptomatic patients, while on flecainide)
- Chance of becoming symptom-free
- 77.7% (95% CI: 56.2%-100%)
Baseline and follow-up characteristics
- Median age
- 27 years (Q1-Q3: 24-38 years)
- Median follow-up time
- 4.2 years (Q1-Q3: 1.6-9.7 years)
- Median daily dose of flecainide
- 150 mg (Q1-Q3: 100-200 mg)
Safety
Side effects
- Reported no side effects
- 21/25, 84%
VT storm while treated with flecainide
- Patients with VT storm (tolerated a lower dose with a good response)
- One
Original publication
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