Low-dose flecainide infusion followed by oral pilsicainide is highly effective and safe for paroxysmal atrial fibrillation.
OBJECTIVE
The aim of this study was to evaluate the efficacy and safety of intravenous infusion of low-dose flecainide (50 mg) followed by oral pilsicainide (50 mg t.i.d.)in patients with paroxysmal atrial fibrillation (AF).


METHODS
Thirty-one patients with symptomatic and hemodynamically stable AF lasting less than 48 h from its onset were enrolled. Firstly, intravenous flecainide was given, and if AF was maintained 1 h after the start of flecainide, oral pilsicainide was started.


RESULTS
Sinus rhythm was restored in 14 patients by flecainide alone (45%), and 24 h later, AF was disappeared in additional 14 patients (45%), resulting in the overall conversion rate of 90%. No side effects were observed.


CONCLUSIONS
The combined therapy of i.v. low-dose flecainide followed by oral pilsicainide might be a promising strategy for the outpatient treatment of paroxysmal atrial fibrillation.
Nagai
Shunichi
S
Nagai Clinic, Yamagata university School of Medicine, Japan.
Takeishi
Yasuchika
Y
Kubota
Isao
I
D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005424:Flecainide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D000889:Anti-Arrhythmia Agents; D008012:Lidocaine; C042288:pilsicainide; D005424:Flecainide