Safely of long-term flecainide and propafenone in the management of patients with symptomatic paroxysmal atrial fibrillation: Report from the flecainide and propafenone Italian study investigators

Chimienti, M; Cullen, Michael; Casadei, Gianluigi

doi:10.1016/s0002-9149(97)89119-9

Cited by 71 publications

(32 citation statements)

References 25 publications

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“…In Western countries, the percentage of patients who maintained sinus rhythm after treatment with the Class I antiarrhythmic agent flecainide (100-300 mg/day) was 61-71% after 6 months of treatment [1][2][3] and 62-77% after 12 months [3][4][5]. The corresponding percentage in patients receiving the Class I agent propafenone (450-1,200 mg/day), was 57% after 6 months [6] and 45-55% after 12 months [4][5][6][7][8].…”

Section: Results Of Studies In Western Countriesmentioning

confidence: 99%

Current strategies of antiarrhythmic drug therapy for paroxysmal atrial fibrillation

Kubo

2012

Journal of Arrhythmia

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a b s t r a c tAtrial fibrillation is now recognized as a significant medical and social problem. Atrial fibrillation not only causes cardiovascular complications, including thromboembolism and heart failure, but also decreases the survival of patients with impaired left ventricular function; thus, it is considered an independent factor for cardiovascular death. The goal of antiarrhythmic drug therapy for atrial fibrillation is improvement of daily quality of life and cardiovascular prognosis in maintaining sinus rhythm, while ensuring the safety of antiarrhythmic drugs. Antiarrhythmic drugs are prescribed to prevent recurrence of atrial fibrillation; however, they demonstrate limited efficacy. Recently, catheter ablation has been established as a promising new therapy to prevent recurrence of atrial fibrillation, even though this procedure would be difficult to apply clinically because of its complications and the large number of patients requiring treatment. Since the antiarrhythmic drugs remain the first-line, primary therapy for paroxysmal atrial fibrillation, clinicians should select appropriate antiarrhythmic drugs for treatment of paroxysmal atrial fibrillation based on individual patient characteristics.Herein, I review the current strategies of antiarrhythmic drug therapy for paroxysmal atrial fibrillation from the point of view of pharmacological prevention of atrial fibrillation recurrence, improvement of patient quality of life, and cardiovascular prognosis.

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Section: Results Of Studies In Western Countriesmentioning

confidence: 99%

Current strategies of antiarrhythmic drug therapy for paroxysmal atrial fibrillation

Kubo

2012

Journal of Arrhythmia

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“…One randomized, openlabel study of 200 patients, for example, demonstrated 1-year efficacy rates of 77% and 75% for flecainide and propafenone, respectively [37]. The limitation with this class of drugs is the risk of ventricular proarrhythmia, particularly in the setting of ischemic heart disease or left ventricular dysfunction.…”

Section: Antiarrhythmic Drugs For Maintenance Of Sinus Rhythmmentioning

confidence: 99%

Atrial fibrillation: Choosing an antiarrhythmic drug

Rudo

Kowey²

2006

Curr Cardiol Rep

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Atrial fibrillation is the most common arrhythmia encountered in clinical practice. The associated hemodynamic changes can lead to symptoms of palpitations, fatigue, light-headedness, or dyspnea. Extensive research in the use of antiarrhythmic drugs has been performed both to facilitate the conversion of atrial fibrillation to sinus rhythm and to maintain normal sinus rhythm. The relative merits of a rhythm control versus rate control strategy are briefly discussed. Efficacy of the available agents for pharmacologic cardioversion is reviewed in detail. Important drugs for maintenance of sinus rhythm include amiodarone, flecainide, propafenone, sotalol, and dofetilide. Selection of the appropriate antiarrhythmic drug must be individualized to the clinical situation, with Class IC drugs being first-line agents in the absence of structural heart disease. Regardless of agent selected, appropriate monitoring for development of adverse effects is of utmost importance.

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“…A systematic analysis of randomized control trials found moderate evidence of efficacy for flecainide for the maintenance of sinus rhythm in patients with persistent or paroxysmal atrial fibrillation [3]. Flecainide appears to have equal efficacy when compared with propafenone for the prevention of paroxysmal atrial fibrillation [4,5]. Similarly, flecainide is effective for the acute cardioversion of atrial fibrillation to sinus rhythm in individuals without organic heart disease [3,6].…”

Section: Pharmacologic Treatmentmentioning

confidence: 99%

“…Similar to other Class IC compounds, propafenone is effective in suppressing nonsustained ventricular arrhythmias in patients with well-preserved left ventricular function and is less effective in patients with sustained ventricular tachyarrhythmias. Propafenone appears to have equal efficacy compared with flecainide in the prevention of paroxysmal atrial fibrillation [4,5]. Propafenone is also as efficacious as sotalol based on data from the CTAF (Canadian Trial of Atrial Fibrillation) [10].…”

Section: Propafenone (Rythmol and Rythmol Sr; Abbott Laboratories Abmentioning

confidence: 99%

Antiarrhythmic drug therapy

Triola

Kowey²

2006

Curr Treat Options Cardio Med

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The use of antiarrhythmic drugs can be challenging to physicians. They are effective in treating various types of arrhythmias, yet their potential to cause adverse events, in particularly proarrhythmia, can be intimidating. When the decision to use antiarrhythmic therapy has been made, physicians are confronted with several issues: choosing the right drug, preventing complications, and selecting the setting in which the drug is to be given (in-hospital vs outpatient). In determining the best antiarrhythmic agent for each patient, one should have a basic understanding of their mechanisms of action and indications. Once this decision has been made, attention turns to avoiding complications and assessing for efficacy. Clinicians should be aware of the common drug interactions of each antiarrhythmic agent and avoid these whenever possible. In addition, patients need meticulous follow-up, including serial electrocardiograms and assessment for cardiovascular side effects. For several of the antiarrhythmic drugs, this can be accomplished in the outpatient setting in appropriate patients.

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Safely of long-term flecainide and propafenone in the management of patients with symptomatic paroxysmal atrial fibrillation: Report from the flecainide and propafenone Italian study investigators

Cited by 71 publications

References 25 publications

Current strategies of antiarrhythmic drug therapy for paroxysmal atrial fibrillation

Current strategies of antiarrhythmic drug therapy for paroxysmal atrial fibrillation

Atrial fibrillation: Choosing an antiarrhythmic drug

Antiarrhythmic drug therapy

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