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Comparing the Efficacy of Carvedilol and Flecainide on the Treatment of Idiopathic Premature Ventricular Complexes from Ventricular Outflow Tract: A Multicenter, Randomized, Open-Label Pilot Study

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Author(s)
Jongmin HwangYong-Seog OhHyoung-Seob ParkJong-Il ChoiYoung Soo LeeEue-Keun ChoiDong-Gu ShinYoung Keun OnTae-Hoon KimHyung Wook ParkMin Soo ChoMyung Hwan BaeSeongwook Han
Keimyung Author(s)
Hwang, Jong MinPark, Hyoung SeobHan, Seong Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
J Clin Med
Issued Date
2023
Volume
12
Issue
8
Keyword
anti-arrhythmia agentscarvedilolventricular premature complexes
Abstract
The mechanism of premature ventricular complexes (PVC) occurring in the ventricular outflow tract (OT) is related to an intracellular calcium overload and delayed afterdepolarizations that lead to triggered activity. The guidelines recommend using beta-blockers and flecainide for idiopathic PVCs, but they also acknowledge the limited evidence supporting this recommendation. We conducted a multicenter, randomized, open-label pilot study comparing the effect of carvedilol and flecainide on OT PVC, which are widely used to treat this arrhythmia. Patients with a 24 h Holter recording a PVC burden ≥ 5%, which showed positive R waves in leads II, III, and aVF, and without structural heart disease were enrolled. They were randomly assigned to the carvedilol or flecainide group, and the maximum tolerated dose was administered for 12 weeks. A total of 103 participants completed the protocol: 51 with carvedilol and 52 with flecainide. After 12 weeks of treatment, the mean PVC burden significantly decreased in both groups: 20.3 ± 11.5 to 14.6 ± 10.8% with carvedilol (p < 0.0001) and 17.1 ± 9.9 to 6.6 ± 9.9% with flecainide (p < 0.0001). Both carvedilol and flecainide effectively suppressed OT PVCs in patients without structural heart disease, with flecainide showing a superior efficacy compared to carvedilol.
Keimyung Author(s)(Kor)
황종민
박형섭
한성욱
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2077-0383
Source
https://www.mdpi.com/2077-0383/12/8/2887
DOI
10.3390/jcm12082887
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44986
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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