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https://www.readbyqxmd.com/read/29904301/flecainide-toxicity-in-renal-failure
#1
Rogin Subedi, Ryan K Dean, Arbind Chaudhary, Tamas Szombathy
Flecainide, a class Ic antiarrhythmic, is used for the prevention of paroxysmal supraventricular tachycardia, paroxysmal atrial fibrillation/flutter, and sustained ventricular tachycardia. Flecainide is primarily metabolized by the liver and to a lesser extent (30%) is excreted unchanged in the kidney. We present a case of flecainide toxicity in the setting of renal impairment that was successfully treated with intravenous sodium bicarbonate.
July 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29899727/flecainide-induced-brugada-syndrome-in-a-patient-with-skeletal-muscle-sodium-channelopathy-a-case-report-with-critical-therapeutical-implications-and-review-of-the-literature
#2
Michele Cavalli, Barbara Fossati, Raffaele Vitale, Elisa Brigonzi, Vito A G Ricigliano, Lorenzo Saraceno, Rosanna Cardani, Carlo Pappone, Giovanni Meola
Skeletal muscle sodium channelopathies are a group of neuromuscular disorders associated with mutations in the SCN4A gene. Because principal sodium channel isoforms expressed in the skeletal muscles and the heart are distinct one from the other, this condition usually spares cardiac functioning. Nonetheless, evidence on a possible link between skeletal muscle and cardiac sodium channelopathies has emerged in recent years. To date, eight patients bearing pathogenetic mutations in the SCN4A gene and manifesting cardiac electrophysiological alterations have been reported in literature...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29848398/pharmacologic-therapy-with-flecainide-for-asymptomatic-wolff-parkinson-white-syndrome-in-an-infant-with-severe-left-ventricular-dyssynchrony
#3
Sayo Suzuki, Tatsunori Hokosaki, Mari Iwamoto
Some asymptomatic patients with Wolff-Parkinson-White syndrome have severe left ventricular dyssynchrony and dysfunction. We describe a patient who was given a diagnosis of Wolff-Parkinson-White syndrome in infancy and had a complete response to pharmacologic therapy with flecainide. Our findings suggest that flecainide is a suitable resynchronisation therapy for such infants.
July 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29787592/which-antiarrhythmic-drug-to-choose-after-electrical-cardioversion-a-study-on-non-valvular-atrial-fibrillation-patients
#4
Hye Bin Gwag, Kwang Jin Chun, Jin Kyung Hwang, Seung-Jung Park, June Soo Kim, Kyoung-Min Park, Young Keun On
The relative efficacy of antiarrhythmic drugs (AADs) after electrical cardioversion are not well established. This study aimed to investigate the efficacies of different AADs for maintaining sinus rhythm (SR) after electrical cardioversion for atrial fibrillation (AF). We selected patients from a retrospective registry including patients admitted for cardioversion between January 2012 and June 2016. The primary outcome was time to AF recurrence during the first year after cardioversion. The secondary outcomes included AF recurrence within 1 month, and first readmission due to heart failure, stroke, or additional non-pharmacological rhythm control...
2018: PloS One
https://www.readbyqxmd.com/read/29782862/evaluation-of-cardiac-arrhythmic-risks-using-a-rabbit-model-of-left-ventricular-systolic-dysfunction
#5
Bianca Hemmeryckx, Yuanbo Feng, Liesbeth Frederix, Marleen Lox, Sander Trenson, Rob Vreeken, Hua Rong Lu, David Gallacher, Yicheng Ni, H Roger Lijnen
Patients with heart disease have a higher risk to develop cardiac arrhythmias, either spontaneously or drug-induced. In this study, we have used a rabbit model of myocardial infarction (MI) with severe left ventricular systolic dysfunction (LVSD) to study potential drug-induced cardiac risks with N-(piperidin-2-ylmethyl)-2,5-bis(2,2,2-trifluoroethoxy)benzamide (flecainide). Upon ligation of the left circumflex arteries, male New Zealand White rabbits developed a large MI and moderate or severe LVSD 7 weeks after surgery, in comparison to SHAM-operated animals...
May 18, 2018: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29774303/myotonia-permanens-with-nav1-4-g1306e-displays-varied-phenotypes-during-course-of-life
#6
Frank Lehmann-Horn, Adele D'Amico, Enrico Bertini, Mauro Lomonaco, Luciano Merlini, Kevin R Nelson, Heike Philippi, Gabriele Siciliano, Frank Spaans, Karin Jurkat-Rott
Introduction: Myotonia permanens due to Nav1.4-G1306E is a rare sodium channelopathy with potentially life-threatening respiratory complications. Our goal was to study phenotypic variability throughout life. Methods: Clinical neurophysiology and genetic analysis were performed. Using existing functional expression data we determined the sodium window by integration. Results: In 10 unrelated patients who were believed to have epilepsy, respiratory disease or Schwartz-Jampel syndrome, we made the same prima facie diagnosis and detected the same heterologous Nav1...
September 2017: Acta Myologica: Myopathies and Cardiomyopathies: Official Journal of the Mediterranean Society of Myology
https://www.readbyqxmd.com/read/29772981/treatment-of-recent-onset-atrial-fibrillation-with-quinidine-and-flecainide-in-thoroughbred-racehorses-107-cases-1987-2014
#7
Yuji Takahashi, Yuhiro Ishikawa, Hajime Ohmura
OBJECTIVE To compare the efficacy of quinidine and flecainide in treating naturally occurring, recent-onset atrial fibrillation (AF) in Thoroughbred racehorses. DESIGN Retrospective case series. ANIMALS 107 Thoroughbred racehorses. PROCEDURES Medical records of racehorses with AF that were treated with quinidine or flecainide between 1987 and 2014 were reviewed. Signalment, history, treatments, complications, and outcome data were collected. Horses were allocated to 2 groups according to the initial treatment: initial treatment with quinidine (group 1) or initial treatment with flecainide (group 2)...
June 1, 2018: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29760739/antiarrhythmic-effects-of-carvedilol-and-flecainide-in-cardiomyocytes-derived-from-catecholaminergic-polymorphic-ventricular-tachycardia-patients
#8
R P Pölönen, K Penttinen, H Swan, K Aalto-Setälä
Mutations in the cardiac ryanodine receptor (RYR2) are the leading cause for catecholaminergic polymorphic ventricular tachycardia (CPVT). In this study, we evaluated antiarrhythmic efficacy of carvedilol and flecainide in CPVT patient-specific induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) carrying different mutations in RYR2. iPSC-CMs were generated from skin biopsies of CPVT patients carrying exon 3 deletion and L4115 or V4653F mutation in RYR2 and of a healthy individual. Ca2+ kinetics and drug effects were studied with Fluo-4 AM indicator...
2018: Stem Cells International
https://www.readbyqxmd.com/read/29758359/probing-flecainide-block-of-i-na-using-human-pluripotent-stem-cell-derived-ventricular-cardiomyocytes-adapted-to-automated-patch-clamping-and-2d-monolayers
#9
Lin Geng, Chi-Wing Kong, Andy O T Wong, Angie Man-Yee Shum, Maggie Z Y Chow, Hui Che, Chenzi Zhang, Ka-Long Yau, Camie W Chan, Wendy Keung, Ronald A Li
Human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) are emerging tools for applications such as drug discovery and screening for pro-arrhythmogenicity and cardiotoxicity as leading causes for drug attrition. Understanding the electrophysiology (EP) of hPSC-CMs is essential but conventional manual patch-clamping is highly laborious and low-throughput. Here we adapted hPSC-CMs derived from two human embryonic stem cell (hESC) lines, HES2 and H7, for a 16-channel automated planar-recording approach for single-cell EP characterization...
May 21, 2018: Toxicology Letters
https://www.readbyqxmd.com/read/29719362/life-threatening-errors-with-flecainide-suspension-in-children
#10
Matthew Grissinger
Errors with flecainide suspension in children.
May 2018: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/29718449/cross-site-reliability-of-human-induced-pluripotent-stem-cell-derived-cardiomyocyte-based-safety-assays-using-microelectrode-arrays-results-from-a-blinded-cipa-pilot-study
#11
Daniel Millard, Qianyu Dang, Hong Shi, Xiaou Zhang, Chris Strock, Udo Kraushaar, Haoyu Zeng, Paul Levesque, Hua-Rong Lu, Jean-Michel Guillon, Joseph C Wu, Yingxin Li, Greg Luerman, Blake Anson, Liang Guo, Mike Clements, Yama A Abassi, James Ross, Jennifer Pierson, Gary Gintant
Recent in vitro cardiac safety studies demonstrate the ability of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) to detect electrophysiologic effects of drugs. However, variability contributed by unique approaches, procedures, cell lines and reagents across laboratories makes comparisons of results difficult, leading to uncertainty about the role of hiPSC-CMs in defining proarrhythmic risk in drug discovery and regulatory submissions. A blinded pilot study was conducted to evaluate the electrophysiologic effects of eight well-characterized drugs on four cardiomyocyte lines using a standardized protocol across three microelectrode array (MEA) platforms (18 individual studies)...
April 27, 2018: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/29668588/a-delayed-diagnosis-of-catecholaminergic-polymorphic-ventricular-tachycardia-with-a-mutant-of-ryr2-at-c-7580t-g-for-6-years-in-a-9-year-old-child
#12
Hongyu Duan, Yongyi Lu, Song Yan, Lina Qiao, Yimin Hua, Yifei Li, Kaiyu Zhou, Chuan Wang
RATIONALE: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare but potentially lethal inherited arrhythmia syndrome induced by adrenergic stress. Due to the atypical clinical manifestations in early age, limited recognition and experience of pediatric cardiologists, and low awareness of the significance of genetic diagnosis in some underdeveloped areas in China, a delayed or missed diagnosis of CPVT in children is common and concerning. PATIENT CONCERNS: A 9-year and 3-month male child with recurrent exercise-induced syncope accompanied by convulsion was initially misdiagnosed as epilepsy since the first manifestation at the age of 3 years...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29661475/usefulness-of-high-dose-oral-flecainide-for-termination-of-recent-onset-atrial-fibrillation-in-children
#13
Leonardo Liberman, Thomas J Starc, Eric S Silver
A high dose of oral flecainide has been used for acute termination of atrial fibrillation (AF) and atrial flutter or intra-atrial re-entry tachycardia (AFL-IART) in adults. The use of flecainide for these conditions in children has not been well described. We describe our institutional experience on acute termination of AF or AFL-IART in children with a single high dose of oral flecainide in a hospital setting. All patients who received a single high dose of oral flecainide from 2009 to 2016 who were <21 years of age were included...
June 15, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29652491/inhibition-of-voltage-gated-k-channel-kv1-5-by-antiarrhythmic-drugs
#14
Rong Chen, Shin-Ho Chung
Molecular dynamics simulations are employed to determine the inhibitory mechanisms of three drugs, 5-(4-phenoxybutoxy)psoralen (PAP-1), vernakalant, and flecainide, on the voltage-gated K+ channel Kv1.5, a target for the treatment of cardiac arrhythmia. At neutral pH, PAP-1 is neutral, whereas the other two molecules carry one positive charge. We show that PAP-1 forms stable dimers in water, primarily through hydrophobic interactions between aromatic rings. All three molecules bind to the cavity between the Ile508 and Val512 residues from the four subunits of the channel...
May 8, 2018: Biochemistry
https://www.readbyqxmd.com/read/29610596/catecholaminergic-polymorphic-ventricular-tachycardia-looking-to-the-future
#15
Andreea Elena Velcea, Calin Siliste, Dragos Vinereanu
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inheritable cardiac disorder, characterized by polymorphic ventricular tachycardia (PVT) or bidirectional ventricular tachycardia, triggered by adrenergic stress, and manifested most frequently as syncope or sudden cardiac death. The disease has a heterogeneous genetic basis, with mutations in the genes encoding the ryanodine and calsequestrin channels accounting for the majority of cases. The diagnosis of CPVT is established in individuals with polymorphic ventricular premature beats, PVT or bidirectional ventricular tachycardia documented during exercise or adrenergic stress, who have a structurally normal heart and normal resting ECG...
December 2017: Mædica
https://www.readbyqxmd.com/read/29609685/stability-of-regularly-prescribed-oral-liquids-formulated-with-syrspend-%C3%A2-sf
#16
M Uriel, C Gómez-Rincón, D Marro
The purpose of this research was to evaluate the stability of 12 oral liquid formulations frequently compounded in hospital and community settings formulated in a specific vehicle: SyrSpend® SF. The stability of melatonin, glycopyrrolate, ciclosporin, chloral hydrate, flecainide acetate, tiagabine HCl, labetalol HCl, ciprofloxacin HCl, spironolactone/hydrochlorothiazide, hydrocortisone, itraconazole and celecoxib in SyrSpend SF PH4 (liquid) was investigated at 0, 30, 60 and 90 days and stored at both controlled room temperature and refrigerated...
April 2, 2018: Die Pharmazie
https://www.readbyqxmd.com/read/29594407/-fatal-flecainide-intoxication-in-a-17-year-old-girl
#17
M Dokter, G Talarico, S Armbrust, E Below, B Bockholdt
A 17-year-old girl was found vomiting and somnolent at home and was taken to a hospital. The girl initially presented with ventricular tachycardia with broad QRS complexes which was very difficult to control. During the course a subsequent cardiogenic shock developed and despite exhaustion of all therapeutic options the fatal outcome could not be averted. The medicolegal autopsy revealed no evidence of any form of violence but the signs of medical treatment. Furthermore, no pathology of internal organs was detected...
May 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29545427/supraventricular-tachycardia-as-a-complication-of-severe-diabetic-ketoacidosis-in-an-adolescent-with-new-onset-type-1-diabetes
#18
Bryan Padraig Finn, Brian Fraser, Susan M O'Connell
Diabetic ketoacidosis (DKA) is one of the most common causes of morbidity and mortality in new-onset type 1 diabetes (T1D). Supraventricular tachycardia (SVT), however, is a very rare complication of DKA. We present the case of a patient with new-onset T1D who presented with DKA. He received intravenous fluid resuscitation, insulin and potassium supplementation and subsequently developed SVT, confirmed on a 12-lead electrocardiograph despite a structurally normal heart. Vagal manoeuvres and adenosine failed to restore sinus rhythm, but flecainide was successful...
March 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29512803/attempted-suicide-by-fl%C3%A3-cainide-overdose-a-case-report
#19
Mouna Ben Kilani, Soufia Naccache, Rami Tlili, Dorra Mbarek, Salma Longo, Youssef Ben Ameur, Mohamed Rachid Boujnah
Class Ic antiarrythmic overdose is associated with a relatively high mortality. We presenta case report regarding a suicidal intoxication of an 18-year old female with a medical history of Wolff-Parkinson-White syndrome. The preliminary examination highlighted a profound cardiovascular collapse. The electrocardiogram showed a PR interval extended to 360 ms. The QRS complexes were enlarged to 360 ms with a right bundle brunch block appearance associated with left posterior hemibloc. There were repolarization abnormalities such as elevation of the J-point, convex ST segment and biphasic T wave in the right precordial leads ("Brugada-Like ECG pattern")...
June 2017: La Tunisie Médicale
https://www.readbyqxmd.com/read/29508636/emerging-pharmacotherapies-for-the-treatment-of-atrial-fibrillation
#20
Alessandro Capucci, Laura Cipolletta, Federico Guerra, Irene Giannini
The main aim of current research on the field of atrial fibrillation (AF) treatment is to find new antiarrhythmic drugs with less side effects. Areas covered: Dronedarone and vernakalant showed promising result in term of efficacy and safety in selected patients. Ranolazine and colchicine are obtaining a role as a potential antiarrhythmic drug. Ivabradine is used in experimental studies for the rate control of AF. Moreover, new compounds (vanoxerine, moxonidine, budiodarone) are still under investigation. Monoclonal antibodies or selective antagonist of potassium channel are under investigation for long term maintenance of sinus rhythm...
March 2018: Expert Opinion on Emerging Drugs
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