Long-term Antiarrhythmic Use (flecainide) is Effective in Maintaining Sinus Rhythm than No Antiarrhythmic Use in Patients with First Developed Paroxysmal Atrial Fibrillation

초록

Introduction | Objectives: There is no detailed guideline recommendation of AAD treatment for the firstly developed paroxysmal atrial fibrillation (AF). Antiarrhythmic drugs (AAD) prevent recurrence of AF and short-term AAD treatment would increase drug safety by reducing treatment duration. We designed the prospective, randomized trial to evaluate the efficacy of short- and long-term AAD (flecainide) compared with no treatment in maintaining sinus rhythm in patients with firstly developed paroxysmal atrial fibrillation (PAF). Methods: Definition of the firstly developed PAF was the patients with firstly developed symptomatic PAF without history of palpitation. Sixty patients were randomly assigned into no AAD treatment (Group I; N = 21), short-term AAD treatment (flecainide 100 mg bid for 4 weeks, Group II; N = 20) or long-term AAD treatment (flecainide 100 mg bid for 6 months, Group III; N = 19). All patients were in sinus rhythm at randomization. Patients received clinical follow up with serial evaluation of rhythm status. Results: There were no significant differences in age, gender, cardiovascular comorbidities and echocardiographic parameters. Among the total population, AF recurred in 16 patients (26.7%) during the follow up period. AF free survival was significantly different among groups (p = .038) (Fig. 1). Conclusions: Long-term AAD at least 6 months is beneficial in maintaining sinus rhythm than no or shot-term AAD in patients with firstly developed PAF.