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European Heart Journal 1990 11(2):145-148;
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

Flecainide acetate in atrial flutter and fibrillation

The arrhythmogenic effects

I. SIHM, F. A. HANSEN, J. RASMUSSEN, A. K. PEDERSEN and K. THYGESEN

Department of Medicine and Cardiology, Aarhus County and University Hospital Aarhus, Denmark

Received 21 February 1989; revised 26 May 1989; .

Correspondence to: Inger Sihm, Department of Medicine and Cardiology, Aarhus County Hospital, Tage Hansensgadc 2, DK 8000 Aarhus C, Denmark.

Abstract

The arrhythmogenic effects of flecainide in atrial fibrillation and flutter were assessed in a consecutive material of 100 patients without severe heart failure (NYHA class I or II). Severe arrhythmogenic events occurred in 9% (4–16%) of the patients: within the first 5 days of treatment in seven patients, and in two patients after 60 and 240 days of flecainide treatment. Patients with proarrhythmic events tended to be older and to have a longer QRS duration. Following flecainide therapy conversion to sinus rhythm was achieved in 21 of 43 patients (49%) with atrial fibrillation and in 10 of 29 (34%) with atrial flutter.It is concluded that flecainide, although an effective antiarrhythmic drug, has potential proarrhythmic effects and therefore cautious use of this drug is mandatory.

Key Words: Flecainide • atrial fibrillation • atrial flutter • proarrhythmogenesis


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