Prospective comparison of flecainide versus quinidine for the treatment of paroxysmal atrial fibrillation/flutter

Gerald Naccarelli, Paul Dorian, Stefan H. Hohnloser, Philippe Coumel

Research output: Contribution to journalArticle

115 Citations (Scopus)

Abstract

In order to compare the efficacy and long-term tolerability of flecainide acetate versus quinidine, 239 patients with paroxysmal atrial fibrillation were prospectively treated with flecainide (n = 122) or quinidine (n = 117) in an open-label, randomized trial. All patients were followed for 1 year after initiation of therapy unless their antiarrhythmic drug was discontinued due to an inadequate therapeutic response or intolerable side effects. Although bath drugs were equally effective in adequately controlling recurrences of atrial fibrillation (difference, p = 0.282; not significant), fewer flecainide patients had to have their therapy discontinued due to adverse experiences (p = 0.012). Based on hath endpoints (efficacy and tolerability), an estimated 70.5% of flecainide versus 55.4% of quinidine patients would remain effectively treated at the end of 1 year on therapy (p ≤0.007). The findings of this prospective study suggest that in the treatment of paroxysmal atrial fibrillation (1) flecainide and quinidine are equally effective in the acceptable suppression of symptomatic paroxysmal atrial fibrillation; (2) flecainide is better tolerated than quinidine and is less likely to be discontinued due to adverse effects; and (3) given the overall endpoint of efficacy and tolerability, more patients are likely to continue long-term therapy with flecainide than with quinidine.

Original languageEnglish (US)
Pages (from-to)53A-59A
JournalAmerican Journal of Cardiology
Volume77
Issue number3
DOIs
StatePublished - Jan 25 1996

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Flecainide
Atrial Flutter
Quinidine
Atrial Fibrillation
Therapeutics
Anti-Arrhythmia Agents
Baths
Prospective Studies
Recurrence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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abstract = "In order to compare the efficacy and long-term tolerability of flecainide acetate versus quinidine, 239 patients with paroxysmal atrial fibrillation were prospectively treated with flecainide (n = 122) or quinidine (n = 117) in an open-label, randomized trial. All patients were followed for 1 year after initiation of therapy unless their antiarrhythmic drug was discontinued due to an inadequate therapeutic response or intolerable side effects. Although bath drugs were equally effective in adequately controlling recurrences of atrial fibrillation (difference, p = 0.282; not significant), fewer flecainide patients had to have their therapy discontinued due to adverse experiences (p = 0.012). Based on hath endpoints (efficacy and tolerability), an estimated 70.5{\%} of flecainide versus 55.4{\%} of quinidine patients would remain effectively treated at the end of 1 year on therapy (p ≤0.007). The findings of this prospective study suggest that in the treatment of paroxysmal atrial fibrillation (1) flecainide and quinidine are equally effective in the acceptable suppression of symptomatic paroxysmal atrial fibrillation; (2) flecainide is better tolerated than quinidine and is less likely to be discontinued due to adverse effects; and (3) given the overall endpoint of efficacy and tolerability, more patients are likely to continue long-term therapy with flecainide than with quinidine.",
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Prospective comparison of flecainide versus quinidine for the treatment of paroxysmal atrial fibrillation/flutter. / Naccarelli, Gerald; Dorian, Paul; Hohnloser, Stefan H.; Coumel, Philippe.

In: American Journal of Cardiology, Vol. 77, No. 3, 25.01.1996, p. 53A-59A.

Research output: Contribution to journalArticle

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