Flecainide useful for achieving and maintaining Sinus rhythm among young patients with rheumatic AF

Key results of the study are:

• A single oral dose of Flecainide achieved SR in 6 patients (24%). Nineteen patients achieved SR after DCC; at 24 h, 21 patients (84%) were in SR.
• With the mean flecainide dose, 16 patients had successful maintenance of SR at six months.
• Researchers reported no significant changes in PR interval, QRS duration or QTc were noted.
• Flecainide was well tolerated.
• At six months, Patients in SR had better functional status, QOL scores and higher LA strain.
• Baseline LA diameter ≤ 61 mm predicted SR at six months (sensitivity/specificity 93.7% and 85.71%), while the values for AF duration ≤ 4 years and LA strain > 21% for predicting SR were 87.5/71.43% and 100/85.71% respectively.

They said that Flecainide may be an attractive modality for achieving and maintaining SR for rheumatic AF.

The study has a small number of patients. More studies need to be carried out with longer follow-ups, they said. The researchers acknowledged the lack of comparison with other drugs as another limitation.

Reference:

Tripathi, U., Kapoor, A., Agarwal, S. K., Tewari, P., Pande, S., Chandra, B., Sahu, A. K., Khanna, R., Kumar, S., Garg, N., & Tewari, S. (2023). Flecainide for conversion and maintenance of sinus rhythm after mitral valve replacement in rheumatic atrial fibrillation. Indian Heart Journal. https://doi.org/10.1016/j.ihj.2023.07.001