Long-term results of hybrid therapy in patients with atrial fibrillation who develop atrial flutter during flecainide infusion.
The flecainide infusion test has been proposed to screen candidates for hybrid pharmacological and ablation therapy. We report the long-term follow-up of 154 consecutive patients with paroxysmal or persistent atrial fibrillation (AF) who developed atrial flutter (AFL) during flecainide infusion (IC AFL), treated with inferior vena cava-tricuspid annulus isthmus catheter ablation and oral flecainide (hybrid therapy). Over a mean of 54.1 +/- 13.1 months 82 patients (53%) remained free of AF and AFL. Flecainide was discontinued because of adverse effects in 6 patients (4%). A history of persistent AF, and the documentation of >/=1 spontaneous AFL episode before the flecainide test were independent predictors of successful hybrid therapy. In patients with paroxysmal AF without documented spontaneous AFL, the long-term efficacy of hybrid therapy was 38.5% (P = 0.03). The flecainide infusion test reliably detects candidates for hybrid therapy. The efficacy of this therapy is maintained over the long-term with a high patient compliance.
Turco
Pietro
P
Laboratorio di Elettrofisiologia, Villa Maria Cecilia Hospital, Cotignola (RA), Italy.
De Simone
Antonio
A
La Rocca
Vincenzo
V
El Jamal
Bilal
B
Nocerino
Pasquale
P
Astarita
Costantino
C
De Matteis
Carmine
C
Messina
Vincenzo
V
Greco
Luciano
L
Rotunno
Raffaele
R
Di Napoli
Tommaso
T
Vitale
Dino Franco
DF
Stabile
Giuseppe
G
D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000601:surgery; D001282:Atrial Flutter / Q000139:chemically induced*; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D005260:Female; D005424:Flecainide / Q000008:administration & dosage / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013997:Time Factors
D000889:Anti-Arrhythmia Agents; D005424:Flecainide