flecainide / Generic mfg. - LARVOL DELTA

Flecainide Toxicity in the setting of Acute Kidney Injury (ASA 2025) - "Treatment for Flecainide toxicity was succesful with fat emulsion 20% (1.5 mL/kg), sodium bicarbonate bolus (200 mEq) and infusion. Prompt recognition of the electrocardiographic findings of Flecainide toxicity and swift intervention are imperative to treat this life-threatening situation."

Acute Kidney Injury • Cardiovascular • Nephrology • Renal Disease

Cardiogenic Shock and Wide Complex Arrhythmias in the Setting of Severe Flecainide Toxicity (ASA 2025) - "We present a case of flecainide toxicity causing multiple wide-complex arrhythmias and refractory cardiogenic shock. Synchronized cardioversion was performed with successful but temporary conversion to sinus rhythm, suggesting this as a viable intervention to temporize hemodynamically unstable patients."

Cardiovascular • Congestive Heart Failure • Heart Failure • Hepatology • Liver Failure • Renal Disease

FLECAINIDE TOXICITY LEADING TO WIDE COMPLEX TACHYARRHYTHMIAS IN THE SETTING OF WORSENING CARDIOMYOPATHY (CHEST 2025) - No abstract available

Cardiomyopathy • Cardiovascular

SUICIDE ATTEMPT VIA OVERT FLECAINIDE OVERDOSE (CHEST 2025) - No abstract available

FLECAINIDE FALLOUT: NAVIGATING WIDE, COMPLEX TACHYCARDIA AND PACEMAKER CAPTURE LOSS (CHEST 2025) - No abstract available

Cardiovascular

OUT OF SYNC: A CASE OF FLECAINIDE TOXICITY (CHEST 2025) - No abstract available

Clinical • Cardiovascular

Management of arrhythmias in mitral valve prolapse: are we making the right choises for our patients? (ESC-WCC 2025) - "Betablocker was the most commonly used antiarrhythmic medication (137 Holter monitorings [45%] in 64 [54%] patients), followed by flecainide (38 [13%) in 13 [3%] patients), non-dihydropyridine calcium channel blocker (11 [4%] in 4 [3%] patients), sotalol (7 [2%] in 2 [2%] patients) and dronedarone (3 [1%] in 1 [1%] patient). Betablocker was the most commonly used antiarrhythmic medication in MVP patients but showed no reduction in ventricular arrhythmias. Flecainide and sotalol were less frequent used but our study suggested a reduction in ventricular arrhythmias. Randomized control trials are needed to assess the efficacy and safety of different antiarrhythmic medications in MVP."

Clinical • Cardiovascular • Ventricular Tachycardia

In-silico insights into the role of patient-specific fibrosis in personalised therapy selection for atrial fibrillation (ESC-WCC 2025) - "Three AAD (vernakalant, amiodarone [acute, chronic], and flecainide) were virtually administered via ionic modulation in CARPentry software. This work highlights the added value of fibrosis-driven personalisation in therapeutic decision-making. It shows how incorporating patient-specific fibrosis more closely aligns success rates with clinical guidelines, offering a framework for personalised treatment."

Clinical • Atrial Fibrillation • Cardiovascular

Flecainide toxicity and BRASH syndrome unmasking severe coronary artery disease: a diagnostic and management challenge (ESC-WCC 2025) - No abstract available

Cardiovascular • Coronary Artery Disease

An aggressive electrophysiologist-guided rhythm control strategy significantly reduces hospital admissions in patients presenting with atrial fibrillation in the emergency department. Data from the HE (ESC-WCC 2025) - "Otherwise, intravenous flecainide was administered and upon failure or in case of contraindications to intravenous flecainide (prior home loading with >300mg propafenone or >200mg flecainide), electrical cardioversion was performed...Rate control was performed in 20% with beta-blockers and verapamil... An aggressive electrophysiologist-guided rhythm control strategy for patients presenting with AF in the ED resulted in a significant reduction in hospital admissions."

Clinical • Atrial Fibrillation • Cardiovascular

The clinical impact of vasovagal syncope in brugada syndrome: assessing the role of holter monitoring in predicting syncope triggered by autonomic reflex activity (ESC-WCC 2025) - " We conducted a study involving 32 patients (75% male, mean age 57 ± 14 years) who underwent a head-up tilt test (70º for 20 minutes, followed by nitroglycerin administration in the absence of symptoms) and 24-hour Holter monitoring to analyze heart rate variability (HRV). All participants were diagnosed with BS, presenting either spontaneous or drug-induced type 1 ECG patterns following flecainide testing... In these patients with Brugada syndrome (BS), we found that vasovagal syncope is highly prevalent, a finding supported by several previous studies. We were unable to identify any significant differences in heart rate variability between patients with increased vasovagal response (positive HUT test) and those without this component. Consequently, the hypothesis of using cardiac pacing to manage syncope triggered by cardioinhibitory mecanism, with Holter monitoring as a screening tool, was not validated."

Clinical • Reflex • Cardiovascular

Early rhythm control in patients with acute decompensated heart failure (ESC-WCC 2025) - "Rhythm control therapy was defined as cardioversion, use of antiarrhythmic drugs (amiodarone, dronedarone, flecainide, or propafenone) or AF ablation. These hypothesis-generating results support the evaluation of early rhythm control for outcome reduction in patients with AHF and AF."

Clinical • Atrial Fibrillation • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Coronary Artery Disease • Heart Failure

Joint relevance of CYP2D6 and H558R in the efficacy and toxicity of flecainide in patients with atrial fibrillation: a cohort study. (ESC-WCC 2025) - "The H558R+/- polymorphism and the CYP2D6 PMs phenotype are independent predictors of a better response to flecainide at 6 and 12 months, respectively. Further studies are needed to confirm the clinical relevance of these findings in real-world practice."

Clinical • Atrial Fibrillation • Cardiovascular

Improving management of patients with atrial fibrillation in the emergency department based on an aggressive rhythm control strategy. The HEROMEDICUS study. (ESC-WCC 2025) - "Otherwise, intravenous flecainide was administered and upon failure or in case of contraindications to intravenous flecainide (prior home loading with >300mg propafenone or >200mg flecainide), electrical cardioversion was performed with the patient fasting for 6 hours and with sedation and analgesia administration (midazolam IV & analgesia IV)...Rate control was performed in 20% with beta-blockers and verapamil... Aggressive rhythm control strategy through implementation of the HEROMEDICUS protocol in the ED showed that 75% of the study population reverted to sinus rhythm and admissions were limited to 4.1%, without compromising safety."

Clinical • Acute Coronary Syndrome • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure

SAVE STROKE II: Assessing the Neurological Outcomes After Atrial Fibrillation Ablation for Rhythm Control (clinicaltrials.gov) - P=N/A | N=100 | Not yet recruiting | Sponsor: Kansas City Heart Rhythm Research Foundation | Initiation date: Jun 2025 ➔ Oct 2025

Trial initiation date • Atrial Fibrillation • Cardiovascular

Fetal Supraventricular Tachycardia: What Do We Know up to This Day? (PubMed, J Pers Med) - "The review, also, focuses on pharmacologic management via transplacental therapy, discussing the safety and efficacy of the key agents including digoxin, flecainide, and sotalol, under different clinical scenarios, such as hydropic fetus and renal impairment...The limitations of current evidence, largely based on small case studies and retrospective analyses, underscore the need for larger, prospective multicenter observational studies and randomized control trials to establish standardized protocols for fetal tachyarrhythmia management. Overall, this review advocates for a personalized, multidisciplinary approach, emphasizing early fetal tachyarrhythmias diagnosis, tailored treatment regimens that balances efficacy with safety, and rigorous monitoring to optimize outcomes for both the fetus and the mother."

Journal • Review • Cardiovascular • Renal Disease • Ventricular Tachycardia

CRISPR activation to repair ECG abnormalities caused by a FLNC truncating variant in mice. (PubMed, Eur Heart J) - "Our heterozygous FLNCtv model partially recapitulates the electrical abnormalities observed in FLNCtv carriers with DCM/NDLVC, offering valuable insight into disease pathogenesis. Most importantly, this study provides the first in vivo demonstration that CRISPRa-AAV-mediated gene activation can effectively treat an inherited cardiomyopathy driven by haploinsufficiency. We show that even after disease onset, electrical dysfunction can be reversed through this targeted therapeutic approach. Our findings open new avenues for broader applications of CRISPRa-AAV platforms in addressing cardiac disorders rooted in insufficient gene dosage."

Journal • Preclinical • Cardiomyopathy • Cardiovascular • Gene Therapies • FLNC

Flecainide mediated sodium channel blockade enhances blood brain barrier integrity and promotes neuroprotection in neuroinflammation. (PubMed, Sci Rep) - "To evaluate the effects and understand the action mechanism of NaV blockers and MAO-B inhibitors (rasagiline, safinamide, flecainide and phenytoin) in neurological conditions, various techniques were used, including optical coherence tomography (OCT), optomotor response measurement (OMR), flow cytometry, histological evaluations, Evans blue assay, blood-brain barrier (BBB) permeability assay, western blot, proliferations assay, and gene expression analyses. The findings demonstrate induced neuroprotection and reduced disease progression, suggesting a novel therapeutic approach. Crucially, it reveals for the first time that NaV 1.5 channel blockade leads to neuroprotection primarily by affecting the BBB, a key factor in controlling immune cell migration, thus addressing a critical aspect of neuroinflammation."

Journal • CNS Disorders • Immunology • Inflammation • Multiple Sclerosis • Ocular Inflammation • Ophthalmology • Optic Neuritis

Flecainide in Structural Heart Diseases: A Contemporary Reappraisal Beyond the CAST Trial. (PubMed, Heart Rhythm) - "Its use also shows promise in various cardiomyopathies such as arrhythmogenic right ventricular cardiomyopathy and premature ventricular complex-induced cardiomyopathy, supporting a nuanced, patient-specific approach that challenges existing flecainide safety dogma and moves beyond outdated misconceptions. Randomized controlled trials are needed to confirm the recent observational findings and redefine the role of flecainide in contemporary cardiology."

Journal • Review • Cardiomyopathy • Cardiovascular • Coronary Artery Disease • Heart Failure • Myocardial Infarction

Pharmacogenetic Study of Antiarrhythmic Drugs for Atrial Fibrillation (clinicaltrials.gov) - P4 | N=162 | Recruiting | Sponsor: University of Illinois at Chicago | Trial completion date: Jun 2025 ➔ Jun 2026 | Trial primary completion date: Jun 2025 ➔ Jun 2026

Biomarker • Trial completion date • Trial primary completion date • Atrial Fibrillation • Cardiovascular

Accessory-pathway-mediated dilated cardiomyopathy in an infant. (PubMed, Cardiol Young) - "No atrioventricular reciprocating tachycardia was reported, but this pre-excitation resulted in left septal dyssynchrony. After the introduction of flecainide therapy, the antegrade pre-excitation disappeared on ECG, leading to normalisation of left ventricular function."

Journal • Cardiomyopathy • Cardiovascular

Fetal tachyarrhythmias: current knowledge for clinical practice. (PubMed, Transl Pediatr) - "In general, studies have been demonstrated the superior efficacy of flecainide and sotalol in comparison to digoxin in the treatment of fetal supraventricular tachycardia (SVT), with or without fetal edema. For sustained ventricular tachycardia (VT), first-line treatment is maternal intravenous magnesium when fetal HR exceeds 200 bpm. In addition, it is important to keep in mind that frequency control is the treatment option for fetuses in which reversal to sinus rhythm has not been successful and pulmonary immaturity is present."

Journal • Review • Cardiovascular • Congestive Heart Failure • Heart Failure • Ventricular Tachycardia

Voltage-gated sodium channels in the nervous system: Molecular physiology to therapeutic interventions. (PubMed, Neural Regen Res) - "It analyzes two major categories of conventional sodium channel blockers and their applications: antiepileptic drugs (such as carbamazepine, lamotrigine, and phenytoin) and antiarrhythmic drugs (such as lidocaine, flecainide, and quinidine)...Additionally, this review evaluates gabapentin, cannabidiol, and calcium channel blockers with different mechanisms of action...This review also highlights advances in gene therapy for specific diseases, such as STK-001, which promotes effective splicing of the SCN1A gene, and ETX101, which utilizes adeno-associated virus 9 vectors to deliver engineered transcription factors...Furthermore, this review summarizes some innovative therapeutic agents in clinical trials, including PRAX-222 (for SCN2A gain-of-function mutation-related epilepsy), which has received Food and Drug Administration orphan drug designation, and the selective Nav1.6 inhibitor NBI-921352 (for SCN8A-related epilepsy). Collectively, this review comprehensively..."

Journal • Autism Spectrum Disorder • CNS Disorders • Epilepsy • Gene Therapies • Genetic Disorders • Migraine • Ophthalmology • Pain • NAV1 • SCN8A

FLECAPRO: Effect and Safety of Flecainide and Metoprolol Versus Metoprolol Alone to Suppress Ventricular Arrhythmias in Arrhythmic Mitral Valve Prolapse (clinicaltrials.gov) - P3 | N=50 | Recruiting | Sponsor: Oslo University Hospital | Trial completion date: Feb 2026 ➔ Jun 2026 | Trial primary completion date: Feb 2026 ➔ Jun 2026

Trial completion date • Trial primary completion date • Cardiovascular

ECG findings in fatal flecainide intoxication. (PubMed, BMJ Case Rep) - No abstract available

Journal