Document Detail


Flecainide for cardioversion in patients at elevated cardiovascular risk and persistent atrial fibrillation: a prospective observational study.
MedLine Citation:
PMID:  20180126     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Flecainide is used as a pill-in-the-pocket treatment for pharmacological cardioversion in patients without structural heart disease and atrial fibrillation (AF). In patients with structural heart disease and elevated cardiovascular risk, flecainide is believed to be harmful. Therefore, data about safety and effectiveness of single-dose flecainide for cardioversion in patients at elevated cardiovascular risk are lacking. OBJECTIVES: One-hundred and six consecutive patients with recent onset AF and known structural heart disease and/or elevated PROCAM-score did receive oral flecainide 300 mg for cardioversion. METHODS: The effectiveness, safety and influencing factors of flecainide for cardioversion in high-risk patients were prospectively assessed. RESULTS: In 43 of 106 patients (40.6%), sinus rhythm could be restored within 192.4 +/- 10.7 min by flecainide. The PROCAM-score was 41.5 +/- 0.56 in patients with successful cardioversion compared to 45.7 +/- 0.74 in patients without successful cardioversion (P < 0.001). ACE-inhibitor co-medication was associated with a significantly lower rate of conversion by flecainide (HR 2.3, 95% CI, 1.12-4.26, P < 0.01). In 58 of 63 patients in whom cardioversion by flecainide was not effective, electrical cardioversion was performed which was successful in 47 patients. Life-threatening arrhythmias did not occur in any patient. The most common side effect was sinus-bradycardia and transient sinus arrest (2-4 s) immediately after conversion. CONCLUSIONS: When monitored properly, flecainide is safe and useful for cardioversion in patients at elevated cardiovascular risk.
Authors:
Fikret Er; Orhan Aslan; Evren Caglayan; Natig Gassanov; Amir M Nia; Erland Erdmann; Stephan Rosenkranz
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-02-24
Journal Detail:
Title:  Clinical research in cardiology : official journal of the German Cardiac Society     Volume:  99     ISSN:  1861-0692     ISO Abbreviation:  Clin Res Cardiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-26     Completed Date:  2010-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264123     Medline TA:  Clin Res Cardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  369-73     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine III, Heart Center of the University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. Fikret.Er@uk-koeln.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Arrhythmia Agents / administration & dosage*
Atrial Fibrillation / drug therapy,  therapy*
Electric Countershock*
Female
Flecainide / administration & dosage*
Humans
Male
Risk Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 54143-55-4/Flecainide

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