Long-term results of hybrid therapy in patients with atrial fibrillation who develop atrial flutter during flecainide infusion

Pietro Turco, Antonio De Simone, Vincenzo La Rocca, Bilal El Jamal, Pasquale Nocerino, Costantino Astarita, Carmine De Matteis, Vincenzo Messina, Luciano Greco, Raffaele Rotunno, Tommaso Di Napoli, Dino Franco Vitale, Giuseppe Stabile

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
JournalPACE - Pacing and Clinical Electrophysiology
Volume28
Issue numberSUPPL. 1
DOIs
Publication statusPublished - Jan 2005

Keywords

  • Ablation
  • Atrial flutter
  • Fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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