Arrhythmias & electrophysiology
Long-Term Follow-Up Data on Flecainide Use as an Antiarrhythmic in Arrhythmogenic Right Ventricular Cardiomyopathy: A Multicenter Study
Authors' conclusion
Flecainide use had a favorable safety profile and was associated with an observed to a significant reduction in arrhythmic burden in patients with ARVC, irrespective of the underlying genotype or LV involvement.
Study context
- Population
- Patients with definite arrhythmogenic right ventricular cardiomyopathy (ARVC) receiving flecainide66 patients (34.6%) showing left ventricular (LV) involvement
- Participants
- 191 patients
- Comparison
- Compared while on and off flecainide
- Outcome
- 24-hour premature ventricular complex burden
Methodological details12 academic institutions
- 12 academic institutions
Main finding
As reported in the abstract
Off flecainide
2,190
On flecainide
418
Further findings
Rate of nonsustained ventricular tachycardia
VA episodes/y, patients with prior VA events
- Rate of nonsustained ventricular tachycardia: P = 0.003
- Ventricular arrhythmia (VA) episodes/y, patients with prior VA events: P < 0.001
Treatment and follow-up
- Median dose of flecainide
- 200 mg/d [150-200 mg/d]
- Also taking a beta-blocker
- 166 patients (86.9%)
- Median follow-up time on flecainide
- 4.2 years [1.9-6.3 years]
Genotype and LV involvement subgroups
- Safety and effectiveness findings consistent across genotype subgroups and in patients with and without LV involvement
Safety
Flecainide discontinuation
- Discontinuation rate
- 7.9%
- Well tolerated
Original publication
Long-Term Follow-Up Data on Flecainide Use as an Antiarrhythmic in Arrhythmogenic Right Ventricular Cardiomyopathy: A Multicenter Study. JACC Clin Electrophysiol. Published 16 April 2025. doi:10.
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