An Investigator-Initiated Prospective Randomized Open-Label Blinded-Endpoint Crossover Trial Comparing the Effect and Safety of Flecainide and Metoprolol Versus Metoprolol Alone to Suppress Ventricular Arrhythmias in Arrhythmic Mitral Valve Prolapse
Status: Recruiting
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 3
SUMMARY
FLECAPRO is a randomized controlled crossover trial assessing the effect and safety of adding flecainide to standard beta-blocker therapy to reduce the burden of ventricular arrhythmias in patients with arrhythmic mitral valve prolapse. The primary endpoint of will be assessed using an implantable loop recorder with blinded endpoint adjudication.
Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
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• Participants must be 18 years of age or older at the time of signing the informed consent.
• Participants must have mitral valve prolapse evident by echocardiography or cardiac magnetic resonance imaging, defined as more than or equal to 2 mm atrial displacement of any part of the mitral leaflets.
• Participants must have ventricular arrhythmias, defined as at least one of the following (i) premature ventricular complex burden ≥3% per 24 hours by Holter monitoring, (ii) premature ventricular complex burden ≥1% per 24 hours if multifocal or occurring in bi-/trigemini and/or couplets by Holter monitoring, (iii) sustained or non-sustained ventricular tachycardia, (iv) aborted cardiac arrest.
• Participants must have a clinical indication for antiarrhythmic treatment due to ventricular arrhythmias.
• Participants must be capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF).
• Participants (only women of childbearing) must accede to mandatory use of a contraceptive method for the duration of the trial and until 3 days after discontinuation of study medication.
Locations
Other Locations
Norway
Oslo University Hospital Rikshospitalet
RECRUITING
Oslo
Contact Information
Primary
Eivind W Aabel, MD PhD
eivind.westrum.aabel@gmail.com
41243148
Time Frame
Start Date:2023-01-04
Estimated Completion Date:2026-06
Participants
Target number of participants:50
Treatments
Experimental: Flecainide and Metoprolol
Participants will receive flecainide 50 mg twice daily (BID), with a dosage target of 100 mg BID. The maximum daily dose of flecainide will not exceed 300 mg. The first dose of flecainide will be initiated in-hospital with a 12-lead electrocardiogram (ECG) taken after 3 hours. If the ECG is considered normal after flecainide treatment, the participant will continue with 50 mg BID from the next day. Participants will receive a dosage of Metoprolol taking into consideration prior beta-blocker use and concomitant medications. The maximum daily dose of metoprolol will not exceed 200 mg. Within the run-in period, the dosage of both Flecainide and Metoprolol will be increased to the maximum tolerable dose.~The Study Team can change the immediate-release formulation of Flecainide to controlled release at the same daily dose of flecainide. Whether metoprolol sustained release will be dosed once daily (QD) or BID, will be up to the investigator and patient preference.
Active_comparator: Metoprolol Alone
Participants will receive a dosage of Metoprolol taking into consideration prior beta-blocker use and concomitant medications. Within the run-in period, the dosage will be increased to the maximum tolerable dose. Whether metoprolol sustained release will be dosed QD or BID, will be up to the investigator and patient preference. The maximum daily dose of metoprolol will not exceed 200 mg.