Document Detail

Combined use of 1C and III agents for highly symptomatic, refractory atrial fibrillation.
MedLine Citation:
PMID:  16917731     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Despite advances in non-pharmacologic therapy for atrial fibrillation (AF), some patients remain highly refractory. OBJECTIVE: We report our experience with the unique combined use of 1C and III agents in patients with highly refractory paroxysmal atrial fibrillation. MATERIALS AND METHODS: Six patients with symptomatic AF (three persistent) were selected after failing multiple antiarrhythmic medications and radiofrequency ablation. They were started on flecainide or propafenone and sotalol or dofetilide during three days of inpatient monitoring. No patient had coronary artery disease. All patients had loop recorder follow-up and ECG recordings during clinic visits for a mean follow-up of 9 +/- 11 months. RESULTS: After therapy, all patients had complete, sustained control of their symptoms with no evidence of AF or proarrhythmia on monitoring. One patient had recurrence of AF after stopping sotalol and was started back on the drug with complete control. CONCLUSIONS: Combined therapy with a 1C and III agent may be an effective alternative for the treatment of selective, highly refractory AF. Careful patient selection and hospitalization for initiation is necessary to minimize potential proarrhythmic effects. As this is a short-term therapy, further study is needed to assess the extent of efficacy in a larger number of patients.
Girish Narayan; Masood Akhtar; Jasbir Sra
Publication Detail:
Type:  Journal Article     Date:  2006-08-18
Journal Detail:
Title:  Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing     Volume:  15     ISSN:  1383-875X     ISO Abbreviation:  J Interv Card Electrophysiol     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-10-04     Completed Date:  2007-03-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708966     Medline TA:  J Interv Card Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  175-8     Citation Subset:  IM    
Electrophysiology Laboratories, Aurora Sinai/St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health-Milwaukee Clinical Campus, Milwaukee, WI, USA.
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MeSH Terms
Anti-Arrhythmia Agents
Atrial Fibrillation / drug therapy*,  prevention & control*
Chronic Disease
Drug Combinations
Flecainide / administration & dosage*
Middle Aged
Phenethylamines / administration & dosage*
Propafenone / administration & dosage*
Recurrence / prevention & control
Sotalol / administration & dosage*
Sulfonamides / administration & dosage*
Treatment Failure
Treatment Outcome
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Drug Combinations; 0/Phenethylamines; 0/Sulfonamides; 115256-11-6/dofetilide; 3930-20-9/Sotalol; 54063-53-5/Propafenone; 54143-55-4/Flecainide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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