Catecholaminergic Polymorphic Ventricular Tachycardia Clinical Trial
Official title:
A Prospective Randomized Crossover Trial of Oral Flecainide for Catecholaminergic Polymorphic Ventricular Tachycardia
The purpose of this study is to test whether the addition of oral flecainide to standard therapy will reduce ventricular ectopy on exercise test compared to placebo plus standard therapy in patients with Catecholaminergic Polymorphic Ventricular Tachycardia.
Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) is a genetic arrhythmia
syndrome characterized by frequent ventricular ectopy and polymorphic, classically
bidirectional ventricular tachycardia with physical or emotional stress, which also carries
a risk of ventricular fibrillation and sudden death, despite no structural heart
abnormality. Treatment consists of beta-blockers and/or calcium channel blockers, but up to
30% of patients require implantable cardioverter-defibrillators (ICDs) due to recurrent
symptoms on medical therapy. In an animal model, flecainide was found to directly target the
molecular defect in CPVT. In a retrospective clinical study in patients with CPVT we have
seen improvement of ventricular ectopy on exercise tests when flecainide is added to
standard therapy. We propose a prospective trial of flecainide added to standard therapy in
CPVT patients to test the hypothesis that flecainide will reduce ventricular ectopy on
exercise testing compared to placebo plus standard therapy.
This will be a single-blind (blinded subjects) randomized cross-over study, in which each
patient will receive treatment A (flecainide or placebo) for at least 3 months and, after a
1 week wash-out, treatment B (placebo or flecainide) for at least 3 months.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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