A randomized comparison of flecainide versus verapamil in paroxysmal supraventricular tachycardia
Identifieur interne : 000331 ( France/Analysis ); précédent : 000330; suivant : 000332A randomized comparison of flecainide versus verapamil in paroxysmal supraventricular tachycardia
Auteurs : Paul Dorian [Canada] ; Gerald V. Naccarelli [États-Unis] ; Philippe Coumel [France] ; Stefan H. Hohnloser [Allemagne] ; Mary Jane Maser [États-Unis]Source :
- The American Journal of Cardiology [ 0002-9149 ] ; 1996.
Abstract
Reentrant paroxysmal supraventricular tachycardias (PSVT) are frequently encountered in clinical practice. Verapamil and flecainide have both been successfully used as chronic oral therapy to prevent PSVT recurrences. This open-label, randomized, multicenter study was designed to compare the efficacy and adverse effects of verapamil (median dose, 240 mg/day) versus flecainide (median dose, 200 mg/day) in patients with frequent and symptomatic attacks of PSVT (other than atrial fibrillation or flutter). A total of 121 patients receiving flecainide (n = 63) or verapamil (n = 58) were followed for 8.1 ±5.1 and 7.5 ± 5.4 months, respectively. Response was judged clinically as effective or not by the treating physician. By life table analysis, 11% discontinued flecainide and 19% discontinued verapamil for inefficacy at 1 year (difference not significant). Both groups showed a marked reduction in the frequency of attacks of PSVT. Before therapy, 71% of flecainide patients and 73% of verapamil patients had ≥2 attacks per month. During therapy, 86% of all flecainide patient-months and 73% of all verapamil patient-months occurred with 0 or 1 attack; 19 (30%) patients on flecainide completed the trial (>270 days) without symptomatic attacks versus 7 (13%) of the patients on verapamil (p = 0.026). Both drugs were well tolerated; 19% of the flecainide group discontinued primarily because of adverse effects, compared with 24% discontinuing verapamil for this reason (difference not significant). Both flecainide and verapamil are effective and well tolerated for the prevention of recurrences of PSVT. For patients in whom radiofrequency ablation procedures cannot be performed or are not indicated, either therapy is a reasonable choice for long-term prophylaxis.
Url:
DOI: 10.1016/S0002-9149(97)89123-0
Affiliations:
- Allemagne, Canada, France, États-Unis
- District de Darmstadt, Hesse (Land), Minnesota, Ontario, Texas, Île-de-France
- Francfort-sur-le-Main, Paris, Toronto
- Université de Toronto
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ISTEX:8AE3FF22CB4D407C6D12A25949D460962077B174Le document en format XML
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Verapamil and flecainide have both been successfully used as chronic oral therapy to prevent PSVT recurrences. This open-label, randomized, multicenter study was designed to compare the efficacy and adverse effects of verapamil (median dose, 240 mg/day) versus flecainide (median dose, 200 mg/day) in patients with frequent and symptomatic attacks of PSVT (other than atrial fibrillation or flutter). A total of 121 patients receiving flecainide (n = 63) or verapamil (n = 58) were followed for 8.1 ±5.1 and 7.5 ± 5.4 months, respectively. Response was judged clinically as effective or not by the treating physician. By life table analysis, 11% discontinued flecainide and 19% discontinued verapamil for inefficacy at 1 year (difference not significant). Both groups showed a marked reduction in the frequency of attacks of PSVT. Before therapy, 71% of flecainide patients and 73% of verapamil patients had ≥2 attacks per month. 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For patients in whom radiofrequency ablation procedures cannot be performed or are not indicated, either therapy is a reasonable choice for long-term prophylaxis.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Canada</li><li>France</li><li>États-Unis</li></country><region><li>District de Darmstadt</li><li>Hesse (Land)</li><li>Minnesota</li><li>Ontario</li><li>Texas</li><li>Île-de-France</li></region><settlement><li>Francfort-sur-le-Main</li><li>Paris</li><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><region name="Ontario"><name sortKey="Dorian, Paul" sort="Dorian, Paul" uniqKey="Dorian P" first="Paul" last="Dorian">Paul Dorian</name></region></country><country name="États-Unis"><region name="Texas"><name sortKey="Naccarelli, Gerald V" sort="Naccarelli, Gerald V" uniqKey="Naccarelli G" first="Gerald V." last="Naccarelli">Gerald V. 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