13th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 1998

January 24-31, 1998
Marilleva, Trento, Italy

RT-156

Use of flecainide before, during and after electrical cardioversion of chronic atrial fibrillation

Marcello Chimienti, Giampaolo Guazzotti*, Serena Barbieri*.
Section of Cardiology, Department of Internal Medicine, University of Pavia, *Policlinic of Monza, Monza, Italy

Introduction

It is well known that in patients with chronic atrial fi-brillation (CAF) the efficacy of external electrical cardioversion (ECV) in restoring sinus rhythm may depend on many variables, such as the amount of delivered current (which in turn depends on the thorax impedance), the number of shocks, the duration of the arrhythmia, the left atrium size, the presence of associated heart disease, etc.^1-4. The overall success rate one should expect from this procedure is usually between 70 and 90%^2,5-10.

The aim of the present study was principally to assess:

a) if chronic treatment with anti-arrhythmic drugs, such as flecainide and amiodarone, before performing ECV, is safe, in terms of complications during ECV (e.g. sinus arrest, bradycardia, junctional rhythm, atrial and ventricular arrhythmias), and effective in favouring sinus rhythm restoration;

b) if intravenous flecainide, given during ECV, is safe and effective in increasing the success rate;

c) if intravenous flecainide, given immediately after successful ECV, may decrease the incidence of early recurrences.

Key Words

Treatment of arrhythmias - pharmacological management  
chronic atrial fibrillation, flecainide, amiodarone, atropine, electrical cardioversion, OA