)Among the 165 patients with recurrences, the drug was effective during all the arrhythmic episodes in 139 (84 percent). There are many different types of beta … Flecainide was effective in 239 of 254 episodes (94 percent), and propafenone in 295 of 315 (94 percent).Sixteen arrhythmic episodes (3 percent) were interrupted after more than 6 hours (range, 390 to 890 minutes) without the patients' contacting the emergency room. One patient (0.6 percent) felt a marked acceleration of heart rate after ingestion of the drug and contacted the emergency room; the electrocardiogram showed atrial flutter, with an atrioventricular conduction ratio of 1:1 and a ventricular rate of 210 beats per minute.

The use of patient-activated transmission of cardiac data by telephone in choosing the arrhythmic episodes to be treated would have enabled us to evaluate more precisely the efficacy of flecainide and propafenone in terminating recurrent episodes of atrial fibrillation. Patients were selected for out-of-hospital treatment from among those who were treated successfully in the hospital and were not excluded during subsequent examination.Before discharge, all patients who had been treated successfully in the hospital were instructed to take the drug five minutes after any subsequent onset of palpitations. Participating centers and investigators included Ospedale Civile, Cento, L. Gianfranchi; Ospedale S. Anna, Como, M. Luzi; Ospedale SS. Interactions may occur with cimetidine, digoxin, diuretics, The first few doses of Tambocor are administered in a Copyright © 2020 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment.

After discharge, patients were seen in the outpatient clinic every four months.All the investigators had full access to the data and performed the data analysis. The remaining 210 patients were discharged and given flecainide (74) or propafenone (136) for pill-in-the-pocket treatment of recurrent atrial fibrillation. The purpose of our study was to investigate the feasibility and safety of the pill-in-the-pocket approach.

Take with food or milk if it causes stomach upset. Of the 268 patients who were treated, 58 were not given out-of-hospital treatment for the following reasons (In Como and Taranto, where all patients with atrial fibrillation of recent onset who came to the emergency room were monitored during the recruiting period, the total number of patients was 541 and the number of patients who were candidates for out-of-hospital treatment was 65 (12 percent).The clinical characteristics of the 210 patients who were discharged and given flecainide or propafenone are reported in The mean follow-up period was 15±5 months (range, 7 to 19) (The mean time from the onset of symptoms to the ingestion of the drug was 36±93 minutes (median, 10).

Finally, patients were advised not to take more than one oral dose during a 24-hour period. The dose we used had previously been demonstrated to be the most suitable for oral treatment.After the exclusion of patients who had a conversion to sinus rhythm after more than six hours or adverse effects during in-hospital treatment, we found that oral flecainide and propafenone interrupted 94 percent of the out-of-hospital arrhythmic episodes, and in 84 percent of the patients, the treatment was effective for all the arrhythmic episodes, with a mean conversion time of about two hours. Betapace (sotalol) and Tambocor (flecainide) are used for treating ventricular arrhythmias.

Data from our study show that the pill-in-the-pocket strategy with flecainide and propafenone is effective for all the arrhythmic episodes in more than 80 percent of patients with recurrent atrial fibrillation, after selection of patients on the basis of clinical features and the results of in-hospital treatment.

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