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Long‐Term Results of Hybrid Therapy in Patients with Atrial Fibrillation Who Develop Atrial Flutter During Flecainide Infusion
Author(s) -
TURCO PIETRO,
DE SIMONE ANTONIO,
LA ROCCA VINCENZO,
EL JAMAL BILAL,
NOCERINO PASQUALE,
ASTARITA COSTANTINO,
DE MATTEIS CARMINE,
MESSINA VINCENZO,
GRECO LUCIANO,
ROTUNNO RAFFAELE,
DI NAPOLI TOMMASO,
VITALE DINO FRANCO,
STABILE GIUSEPPE
Publication year - 2005
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2005.00032.x
Subject(s) - flecainide , medicine , atrial flutter , atrial fibrillation , cardiology , catheter ablation , anesthesia
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.