Encainide for treatment of atrioventricular reciprocating tachycardia in the Wolff-Parkinson-White syndrome

William M. Miles, Douglas P. Zipes, Robert L. Rinkenberger, Michael L. Markel, Eric N. Prystowsky, Anne H. Dougherty, James J. Heger, Gerald V. Naccarelli

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Abstract

Oral encainide, varying from 75 to 300 mg/day (mean 174 mg/day), was administered to 52 patients with drug-resistant atrioventricular reciprocating tachycardia (AVRT) associated with the Wolff-Parkinson-White syndrome. Electrophysiologic studies were performed before and during drug treatment. Encainide resulted in anterograde accessory pathway block in 15 of 37 (41%) and retrograde accessory pathway block in 11 of 46 (24%) patients. In patients With residual accessory pathway conduction, encainide significantly prolonged the shortest pacing cycle length maintaining anterograde (261 ± 26 to 404 ± 85 ms) and retrograde (279 ± 46 to 436 ± 87 ms) accessory pathway conduction, as well as the anterograde accessory pathway effective refractory period (271 ± 32 to 329 ± 73 ms). AVRT could not be induced during encainide therapy in 20 of 49 patients (41%). In the remaining patients, AVRT cycle length increased (319 ± 44 to 426 ± 90 ms, p <0.001) due to prolongation of HV and ventriculoatrial intervals. During follow-up (mean 38.5 months), 30 patients continued to take the drug and 7 patients with favorable drug response subsequently elected to undergo surgical accessory pathway ablation (71% overall favorable response). Encainide was ineffective in 11 patients, was discontinued because of drug intolerance in 2 patients and exacerbated ventricular tachycardia in 2 patients. Lack of AVRT inducibility at encainide electrophysiologic study did not always predict recurrence-free follow-up. Encainide is an effective and well-tolerated drug to prevent recurrence of AVRT in patients with Wolff-Parkinson-White syndrome.

Original languageEnglish (US)
Pages (from-to)L20-L25
JournalThe American journal of cardiology
Volume62
Issue number19
DOIs
StatePublished - Dec 20 1988

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Miles, W. M., Zipes, D. P., Rinkenberger, R. L., Markel, M. L., Prystowsky, E. N., Dougherty, A. H., Heger, J. J., & Naccarelli, G. V. (1988). Encainide for treatment of atrioventricular reciprocating tachycardia in the Wolff-Parkinson-White syndrome. The American journal of cardiology, 62(19), L20-L25. https://doi.org/10.1016/0002-9149(88)90011-2