Safety and efficacy of flecainide for patients with catecholaminergic polymorphic ventricular tachycardia: A systematic review and meta-analysis.

ABSTRACT:

Background

Owing to reports of recurrent cardiac events in some catecholaminergic polymorphic ventricular tachycardia (CPVT) patients using ?-blockers, safer alternatives are being investigated. Flecainide is an alternative adjunctive anti-arrhythmic agent known to provide incomplete protection to CPVT patients.

Methods

To investigate the efficacy and tolerability of flecainide, we searched 4 databases for retrospective cohort studies (RCs) and randomized controlled trials (RCTs) investigating the efficacy and safety of flecainide for CPVT patients. Data were extracted and analyzed (risk ratio [RR] or mean difference [MD]) using RevMan software. Seven RCs and 1 RCT (333 CPVT patients; 152 patients treated with flecainide) were identified.

Results

Flecainide monotherapy was superior to standard therapy in alleviating the risk of arrhythmic events (RR?=?0.46, confidence interval [CI]?=?[0.38, 0.56], P?ConclusionsFlecainide is an effective and safe anti-arrhythmic agent, and its use as a monotherapy might be a good alternative for CPVT patients with ?-blocker intolerance. Combination therapy was superior to ?-blocker monotherapy. More randomized clinical trials are required to explore the long-term efficacy and safety of flecainide in these patients.

SUBMITTER: Wang G 

PROVIDER: S-EPMC6716729 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature