title: Long-term results of hybrid therapy in patients with atrial fibrillation who develop atrial flutter during flecainide infusion.
abstract: 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.
authors.affiliation: Laboratorio di Elettrofisiologia, Villa Maria Cecilia Hospital, Cotignola (RA), Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Turco
authors.forename: Antonio
authors.initials: A
authors.lastname: De Simone
authors.forename: Vincenzo
authors.initials: V
authors.lastname: La Rocca
authors.forename: Bilal
authors.initials: B
authors.lastname: El Jamal
authors.forename: Pasquale
authors.initials: P
authors.lastname: Nocerino
authors.forename: Costantino
authors.initials: C
authors.lastname: Astarita
authors.forename: Carmine
authors.initials: C
authors.lastname: De Matteis
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Messina
authors.forename: Luciano
authors.initials: L
authors.lastname: Greco
authors.forename: Raffaele
authors.initials: R
authors.lastname: Rotunno
authors.forename: Tommaso
authors.initials: T
authors.lastname: Di Napoli
authors.forename: Dino Franco
authors.initials: DF
authors.lastname: Vitale
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Stabile
mesh_terms: 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
chemical_list: D000889:Anti-Arrhythmia Agents; D005424:Flecainide