title: Efficacy of flecainide acetate for atrial arrhythmias following coronary artery bypass grafting.
abstract: The antiarrhythmic efficacy of intravenous flecainide and intravenous digoxin was assessed in 29 patients (26 men), aged 43 to 73 (63 +/- 7) years who developed atrial arrhythmias in the first 96 hours after coronary artery bypass grafting. Twenty-seven had atrial fibrillation and 2 had atrial flutter. Patients were entered into the study if the arrhythmia persisted for at least 15 minutes with a ventricular rate greater than 120 beats/min. Fifteen patients were randomized to flecainide (group 1) and 14 to digoxin (group 2). Flecainide was given as a bolus of 1 mg/kg over 10 minutes followed by an infusion of 1.5 mg/kg/hr for 1 hour and then 0.25 mg/kg/hr for the rest of the study period (24 hours). Digoxin was given as 3 bolus doses (0.5 mg followed after 6 and 12 hours by 0.25 mg). In both groups, 10 mg of verapamil was given intravenously after 45 minutes if the arrhythmia persisted with a mean ventricular rate greater than 100 beats/min. The antiarrhythmic efficacy was assessed by 24-hour Holter monitoring and frequent 15-second rhythm strips. Within 45 minutes control of arrhythmia, which was maintained for the rest of the study period, was achieved in 10 of 15 patients in group 1 and 2 of 14 in group 2 (p less than 0.01). Nine of 15 reverted to sinus rhythm in group 1 compared to 0 of 14 in group 2 and 1 of 15 remained in arrhythmia with a controlled ventricular rate in group 1 compared to 2 of 14 in group 2.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Cardiological Sciences, St. George's Hospital Medical School, London, England.
authors.forename: S S
authors.initials: SS
authors.lastname: Wafa
authors.forename: D E
authors.initials: DE
authors.lastname: Ward
authors.forename: D J
authors.initials: DJ
authors.lastname: Parker
authors.forename: A J
authors.initials: AJ
authors.lastname: Camm
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000209:etiology; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004077:Digoxin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005424:Flecainide / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D014700:Verapamil / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D004077:Digoxin; D014700:Verapamil; D005424:Flecainide