Flecainide in quinidine-resistant atrial fibrillation
Autor: | Jean-François Leclercq, Fabrice Chouty, Isabelle Denjoy, Robert Slama, Philippe Coumel |
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Rok vydání: | 1992 |
Předmět: |
Male
Quinidine medicine.medical_specialty Time Factors Sinus bradycardia Amiodarone Internal medicine Atrial Fibrillation medicine Humans cardiovascular diseases Myocardial infarction Flecainide Ejection fraction business.industry Arrhythmias Cardiac Atrial fibrillation Middle Aged medicine.disease Anesthesia Electrocardiography Ambulatory cardiovascular system Cardiology Drug Therapy Combination Female medicine.symptom Cardiology and Cardiovascular Medicine business Atrial flutter Follow-Up Studies medicine.drug |
Zdroj: | The American Journal of Cardiology. 70:A62-A65 |
ISSN: | 0002-9149 |
DOI: | 10.1016/0002-9149(92)91080-n |
Popis: | Flecainide (100 mg twice daily) was used for prevention of paroxysmal atrial fibrillation (PAF) in 52 patients with frequent symptomatic attacks that were resistant or intolerant to quinidine (600-900 mg/day). Underlying heart disease was present in only 8 cases and left ventricular ejection fraction was always greater than 30%. No patient had had a myocardial infarction. Vagally induced PAF was clinically documented in 35 patients. Amiodarone, previously used and ineffective, was combined with flecainide in 33 patients. After 1-5.8 years of follow-up, complete disappearance of PAF was observed in 38 patients (73%). The success rate was slightly higher in patients with vagally induced PAF (p = 0.07). Extracardiac side effects necessitated withdrawal in only 3 cases. Permanent pacemaker was needed in 7 patients on amiodarone and flecainide because of excessive sinus bradycardia. Two patients, with previously documented atrial flutter, experienced presyncopal episodes of atrial flutter with 1:1 atrioventricular (AV) conduction and wide QRS complex. No death occurred during the follow-up. In this series, quinidine proved to be unsuccessful in 46 patients and it was withdrawn in 6. We concluded that flecainide is efficient and well tolerated for long-term prevention of PAF in patients resistant to quinidine. The possibility of 1:1 AV conduction during atrial flutter may suggest the use of verapamil or beta blockers in combination with flecainide in patients with previously documented atrial flutter. |
Databáze: | OpenAIRE |
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