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European Heart Journal 1993 14(3):421-424;
Copyright © 1993 by the European Society of Cardiology.
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© 1993 The European Society of Cardiology

Effects of flecainide on termination of atrial flutter by rapid atrial pacing

M. HELDAL and O. M. ORNING

Section of Cardiology, Department of Medicine, Aker University Hospital Oslo, Norway

Received 9 January 1992; revised 10 July 1992; .

Correspondance: Dr Magnus Heldal, Medisinskavd, 0514 Aker sykehus, Oslo, Norway

Abstract

Rapid atrial pacing is effective in terminating atrial flutter, but often results in transient or permanent atrial fibrillation rather than sinus rhythm. Class Ia antiarrhythmic drugs have earlier been shown to facilitate the direct conversion of atrial flutter to sinus rhythm. The present study was performed to test the hypothesis that flecainide, a group 1c antiarrhythmic drug, increases the direct conversion to sinus rhythm. In a series of 30 consecutive clinical episodes of atrial flutter treated with rapid atrial pacing, 12 episodes were in patients on flecainide treatment (group A), while in 13 episodes no patients were on group 1 antiarrhythmic drugs (group B). Direct conversion to sinus rhythm was achieved more often in group A (75%) than in group B (31%) P = 0.034. Both the flutter rates and the pacing rates used were lower in group A, 240 vs 280 beat. Min–1 and 375 vs 430 b. min–1, respectively. Patients with atrial flutter in whom rapid atrial pacing is to be performed should be considered for pretreatment with flecainide.

Key Words: Atrial flutter • cardiac pacing artificial • flecainide


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