Avoid drugs in m:ent-ilnset atrial fibrillation

THERAPY

Drug therapy may provide little benefit in rteenl-onset atri al fibrillation . This is the conclusion of researchers from Australia who examined the effect s of IV flecainide 2 mglkg and IV amiodarone 7 mglkg in a placebo-controlled trial involving 98 paticms.

Flecai nide , but nOI amiodarone, gave an increase in early « 2 hours) reversion to sinus rh ythm. However. al the end of the 8-hour study period reversion rates were the same whether patients had received a drug or placebo. No patient in the study required urgent electrical cardioversion because of haemodynamic deterioration.

Citing the risk of adverse effects and the high rate of spontaneous reversion to sinus rhythm , the investigators question the use of either drug. If early reversion is required, they recommend IV fl ecai nide.

DonoY:an KD. Power BM. Hocliliol" BEF. Dobb CiJ. Lee K· Y. !mrave"",,"

fIcainlde _cnu' ~ for _ loOI1SeIlU'i.al fibrillation. Amcric:an Journ&! ofCWioloey 7S :693-69'/, I Apr 1m _..."

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