Why the study?
What is the incidence of arrhythmogenic effects and the rate of conversion to sinus rhythm with flecainide in patients with atrial fibrillation and flutter?
What is the incidence of arrhythmogenic effects and the rate of conversion to sinus rhythm with flecainide in patients with atrial fibrillation and flutter?
Flecainide is effective for converting atrial fibrillation and flutter to sinus rhythm but carries a 9% risk of severe proarrhythmic events, necessitating cautious use.
May warrant arrhythmia monitoring with flecainide in AF/flutter; leaves open randomized confirmation of safety and efficacy.
The arrhythmogenic effects of flecainide in atrial fibrillation and flutter were assessed in a consecutive material of 100 patients without severe heart failure (NYHA class I or II). Severe arrhythmogenic events occurred in 9% (4-16%) of the patients: within the first 5 days of treatment in seven patients, and in two patients after 60 and 240 days of flecainide treatment. Patients with proarrhythmic events tended to be older and to have a longer QRS duration. Following flecainide therapy conversion to sinus rhythm was achieved in 21 of 43 patients (49%) with atrial fibrillation and in 10 of 29 (34%) with atrial flutter. It is concluded that flecainide, although an effective antiarrhythmic drug, has potential proarrhythmic effects and therefore cautious use of this drug is mandatory.
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Sihm et al. (1990) studied this question.
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