title: Low-dose flecainide infusion followed by oral pilsicainide is highly effective and safe for paroxysmal atrial fibrillation.
abstract: 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.
authors.affiliation: Nagai Clinic, Yamagata university School of Medicine, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Nagai
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Takeishi
authors.forename: Isao
authors.initials: I
authors.lastname: Kubota
mesh_terms: 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
chemical_list: D000889:Anti-Arrhythmia Agents; D008012:Lidocaine; C042288:pilsicainide; D005424:Flecainide