Arrhythmias and Conduction DisturbancesRadiofrequency ablation of atrial flutter due to administration of class IC antiarrhythmic drugs for atrial fibrillation
Section snippets
Patients
The study population consisted of 187 patients from a local AF registry with paroxysmal AF who were orally treated with 150 to 250 mg flecainide (n = 96) or 300 to 900 mg propafenone (n = 91). If a patient developed stable, documented AFl throughout the course of drug treatment, that patient was included in the study group. Twenty consecutive, randomized patients without evidence of AFl due to class IC drug trials formed the control group. All patients continued their preexisting drug treatment.
Incidence of atrial flutter
Twenty-four of 187 registered patients (12.8%) developed AFl during the course of class IC drug treatment. Thirteen of these patients received flecainide (13.5%) and 11 patients propafenone (12.1%) (p = NS). Common-type AFl with inverted flutter waves in leads II, III, and aVF was found in 18 patients and uncommon-type AFl with biphasic or upright flutter waves in 6 patients. In none of the patients was there documented AFl before drug treatment. Twenty consecutive, randomized patients without
Impact on therapy for atrial fibrillation
Currently, long-term antiarrhythmic drug administration remains the mainstay of therapy in patients with paroxysmal AF. However, recurrence rates are still high. In this study, we investigated the effects of AFl ablation and continuation of drug therapy on AF recurrence rates in patients with AFl due to administration of class IC antiarrhythmic drugs. It was found that catheter ablation of drug-related AFl and continuation of drug therapy is highly effective in reducing AF episodes in these
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