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Abstract：
BACKGROUND: Beta-blockers (BB) or dihydropyridine calcium channel blockers (CCBs) are still the first choices in the treatment of idiopathic premature ventricular complexes (PVCs), with low-modest efficacy. Antiarrhythmic drugs (AADs) of Ic class are moderate to highly efficient but the evidence on their benefits is still limited.
OBJECTIVE: To compare effectiveness and safety of flecainide, propafenone, and sotalol in the treatment of symptomatic idiopathic PVCs.
METHODS: Our single-center retrospective study analyzed 104 consecutive patients with 130 medication episodes of frequent idiopathic PVCs treated with AADs flecainide, propafenone (Ic class) or sotalol (III class). The primary outcome was complete/near complete reduction of PVCs after medication episode (PVCs burden reduction >99%), and the secondary outcome was significant PVC burden reduction (≥80%).
RESULTS: The complete/near complete PVCs burden reduction occurred in 31% and was significant in 43% of treated patients. A reduction of PVC burden for >99% was achieved in 56% of patients on flecainide, in 11% of patients on propafenone (p = .002), and in 21% of patients receiving sotalol (p = .031). There was no difference between propafenone and sotalol (p = .174). A reduction of PVC burden for ≥80% was achieved in 64% of patients on flecainide, in 30% of patients on propafenone (p = .009), and 33% of patients on sotalol (p = .020). There was no difference between propafenone and sotalol (p = .661).
CONCLUSIONS: The efficacy of AADs class Ic and III in the treatment of idiopathic PVCs was modest. Flecainide was the most effective AAD in the achievement of complete/near complete or significant PVC burden reduction, compared to propafenone and sotalol.
OBJECTIVE: To compare effectiveness and safety of flecainide, propafenone, and sotalol in the treatment of symptomatic idiopathic PVCs.
METHODS: Our single-center retrospective study analyzed 104 consecutive patients with 130 medication episodes of frequent idiopathic PVCs treated with AADs flecainide, propafenone (Ic class) or sotalol (III class). The primary outcome was complete/near complete reduction of PVCs after medication episode (PVCs burden reduction >99%), and the secondary outcome was significant PVC burden reduction (≥80%).
RESULTS: The complete/near complete PVCs burden reduction occurred in 31% and was significant in 43% of treated patients. A reduction of PVC burden for >99% was achieved in 56% of patients on flecainide, in 11% of patients on propafenone (p = .002), and in 21% of patients receiving sotalol (p = .031). There was no difference between propafenone and sotalol (p = .174). A reduction of PVC burden for ≥80% was achieved in 64% of patients on flecainide, in 30% of patients on propafenone (p = .009), and 33% of patients on sotalol (p = .020). There was no difference between propafenone and sotalol (p = .661).
CONCLUSIONS: The efficacy of AADs class Ic and III in the treatment of idiopathic PVCs was modest. Flecainide was the most effective AAD in the achievement of complete/near complete or significant PVC burden reduction, compared to propafenone and sotalol.
摘要：
背景：β受体阻滞剂（BB）或二氢吡啶钙通道阻滞剂（CCB）仍然是治疗特发性室性早搏综合征（PVC）的首选，具有低-适度的疗效。Ic类抗心律失常药物（AAD）是中等至高效的，但有关其益处的证据仍然有限。
目的：为了比较氟卡尼的有效性和安全性，普罗帕酮,和索他洛尔治疗有症状的特发性PVCs。
方法：我们的单中心回顾性研究分析了使用氟卡尼治疗的104例频繁特发性PVC的连续130例药物发作，普罗帕酮（Ic类）或索他洛尔（III类）。主要结果是药物发作后PVCs完全/接近完全减少（PVCs负担减少>99%），次要结局是显著降低PVC负担(≥80%)。
结果：完全/接近完全的PVCs负担减少发生在31%，而在43%的接受治疗的患者中是显著的。在服用氟卡尼的56％的患者中，PVC负担减少了>99％，在11%的普罗帕酮患者中（p=0.002），21%的患者接受索他洛尔（p=0.031）。普罗帕酮和索他洛尔之间没有差异（p=0.174）。64％的患者使用氟卡尼，PVC负荷降低≥80％，在30%服用普罗帕酮的患者中（p=.009），33%的患者服用索他洛尔（p=0.020）。普罗帕酮和索他洛尔之间没有差异（p=.661）。
结论：Ⅰ级和Ⅲ级AADs治疗特发性PVCs的疗效一般。氟卡尼是实现完全/接近完全或显著降低PVC负荷的最有效的AAD，与普罗帕酮和索他洛尔相比。
目的：为了比较氟卡尼的有效性和安全性，普罗帕酮,和索他洛尔治疗有症状的特发性PVCs。
方法：我们的单中心回顾性研究分析了使用氟卡尼治疗的104例频繁特发性PVC的连续130例药物发作，普罗帕酮（Ic类）或索他洛尔（III类）。主要结果是药物发作后PVCs完全/接近完全减少（PVCs负担减少>99%），次要结局是显著降低PVC负担(≥80%)。
结果：完全/接近完全的PVCs负担减少发生在31%，而在43%的接受治疗的患者中是显著的。在服用氟卡尼的56％的患者中，PVC负担减少了>99％，在11%的普罗帕酮患者中（p=0.002），21%的患者接受索他洛尔（p=0.031）。普罗帕酮和索他洛尔之间没有差异（p=0.174）。64％的患者使用氟卡尼，PVC负荷降低≥80％，在30%服用普罗帕酮的患者中（p=.009），33%的患者服用索他洛尔（p=0.020）。普罗帕酮和索他洛尔之间没有差异（p=.661）。
结论：Ⅰ级和Ⅲ级AADs治疗特发性PVCs的疗效一般。氟卡尼是实现完全/接近完全或显著降低PVC负荷的最有效的AAD，与普罗帕酮和索他洛尔相比。
