Drug Drops AFib Stroke Risk

Flecainide helps prevent arrhythmia related strokes in the short term

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) For most patients with a heart rhythm disorder called atrial fibrillation, a procedure that uses electrical currents can successfully restore a normal heart rhythm.

However, an arrhythmia recurrence is common in the weeks after the treatment.

A recent study showed that short-term treatment with flecainide (Tambocor), following electrical cardioversion appears to lower the chance of relapses within weeks of the procedure.

Atrial fibrillation is associated with an increased risk of stroke, and can contribute to heart failure.

"Ask your cardiologist to explain all of your treatments."

Paulus Kirchhof, MD, a professor and chair of cardiovascular medicine at the University of Birmingham, said that the findings could have implications for better treating selected patients. Though the short-term drug treatment is inferior to longer-term treatment, it still should be considered for high-risk atrial fibrillation patients, he said.

During the initial four weeks after electrical cardioversion, patients are at a higher risk of a recurrent arrhythmia while an electrical reorganization occurs within the heart. Drug treatment helps reverse a portion of this remodeling.

The risk of recurrence is substantially lower after the four-week mark.

Patients generally take medication to prevent recurrences long-term following the procedure, though researchers have suggested an effective short-term treatment could be safer, cheaper and appropriate for a larger number of patients.

Researchers from AFNET, the German Competence Network on Atrial Fibrillation, followed more than 600 atrial fibrillation patients at 44 German centers between 2007 and 2010 during the randomized study.

Randomly selected patients took flecainide for four weeks or six months following electrical cardioversion. One group did not receive either treatment.

The patients were checked for relapses through daily ECGs for six months. Among the patients who received treatment for four weeks, 120 of 261 relapsed. In the longer treatment group, 103 of 263 had a recurrent bout of atrial fibrillation.

Investigators found that the six-month treatment option prevented a larger number of recurrences, though the shorter treatment also reduced occurrences.

They determined that the shorter-term therapy was 80 percent as effective as the six-month treatment option.

The study was recently published in the Lancet.

Reviewed by: 
Review Date: 
June 18, 2012
Last Updated:
June 21, 2012