Why the study?
Does pill-in-the-pocket therapy with class IC antiarrhythmics safely cardiovert paroxysmal atrial fibrillation and reduce hospital visits?
Does pill-in-the-pocket therapy with class IC antiarrhythmics safely cardiovert paroxysmal atrial fibrillation and reduce hospital visits?
Pill-in-the-pocket therapy with class IC antiarrhythmics is an effective and safe out-of-hospital strategy to terminate paroxysmal atrial fibrillation and reduce healthcare utilization.
May support NP-led PIP class IC therapy for eligible PAF; leaves open prospective trials before practice change.
This review highlights an evidence-based approach for patients with paroxysmal atrial fibrillation (PAF) using class IC antiarrhythmic therapy. After ensuring patients are eligible for pill-in-the-pocket (PIP) therapy and after successful trialing of PIP in a monitored environment, nurse practitioners can prescribe an oral atrioventricular nodal blocker, followed by class IC antiarrhythmic therapy, to chemically cardiovert PAF into normal sinus rhythm in an unmonitored out-of-hospital setting. Given the safety and success rates of PIP drugs, this method reduces emergency department visits and hospitalizations and is considered an effective first-line treatment approach to terminate PAF.
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Hussein et al. (2024) studied this question.
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