No other antiarrhythmic showed a significant effect on mortality compared with controls .
Class IA , IC , and III drugs are effective in maintaining sinus rhythm but increase adverse effects , and class IA drugs may increase mortality
BACKGROUND A variety of antiarrhythmic drugs have been used to prevent recurrence of atrial fibrillation after conversion to sinus rhythm .
We performed a systematic review to determine the effect of long-term treatment with those drugs on death , embolisms , adverse effects , and atrial fibrillation recurrence .
Safety of long-term flecainide and propafenone in the management of patients with symptomatic paroxysmal atrial fibrillation: report from the Flecainide and Propafenone Italian Study Investigators.
To compare the relative safety of flecainide acetate to propafenone HCl during long-term treatment ( 12 months ) , we conducted a r and omized , open-label , comparative , parallel , multicenter trial in 200 patients with paroxysmal atrial fibrillation ( AF ) and no history of heart disease . Initial daily doses were flecainide 200 mg ( n = 97 ) or propafenone 450 mg ( n = 103 ) . Dose escalations up to a maximum of flecainide 300 mg/day or propafenone 900 mg/day were permitted after > or = 2 attacks of paroxysmal AF . Patients were assessed for safety and drug tolerance at design ated intervals over the 12-month study unless discontinued for adverse experience or inadequate response . Ten patients on flecainide  reported 14 cardiac adverse experiences ; 4 discontinued the drug . Seven  propafenone  patients reported 8 cardiac adverse experiences ; 5 discontinued the drug . Three proarrhythmic events occurred : 1 propafenone patient developed ventricular tachycardia and 2 flecainide patients experienced AF with a rapid ventricular response . An intention-to-treat analysis showed that the probability of safe and effective treatment after 12 months was 77 % for flecainide-treated patients and 75 % for the propafenone-treated patients . There was an acceptable risk-benefit profile in patients with paroxysmal AF and no evidence of clinical ly significant heart disease who were treated with flecainide or propafenone for 12 months . Further , there was no statistically significant difference in safety or efficacy between flecainide and propafenone in this study
No other antiarrhythmic showed a significant effect on mortality compared with controls .
Class IA , IC , and III drugs are effective in maintaining sinus rhythm but increase adverse effects , and class IA drugs may increase mortality
BACKGROUND A variety of antiarrhythmic drugs have been used to prevent recurrence of atrial fibrillation after conversion to sinus rhythm .
We performed a systematic review to determine the effect of long-term treatment with those drugs on death , embolisms , adverse effects , and atrial fibrillation recurrence .